This e-Newsletter offers the most up-to-date and essential news and information about the transition to ICD-10. If you would prefer not to receive these monthly updates, you can change your email preferences in your account.
ICD-10-CM: How do we stack up to other countries?
ICD-10 is already being used in more than 100 countries for cause of death reporting and statistics. However, other countries do not code farther than the 5th character, so no other country gets close to the 69,000 codes we will use in the United States.
For instance, in ICD-10-GM (German Modification), providers can stop coding at the 3rd character and submit the code with three characters and a hyphen. This means that a code could be submitted as Z52.- for donors of organs and tissues, instead of choosing one of the twenty-six more specific codes in the subcategories (e.g., Z52.001, Unspecified donor, stem cell).
With the United States' implementation of ICD-10, we will have a much greater ability to track diseases and treatment. But what does all this new information mean for our coders/billers/auditors/managers? It means we have a bigger learning curve for the code set.
The U.S. Implementation Will Require:
- A full understanding of anatomy and physiology, medical terminology, and disease processes.
- Providers who understand the specificity of the code system so they know what needs to be in the medical record to validate an ICD-10-CM code selection.
According to ICD-10-CM readiness evaluations performed by AAPC Physician Services, more than a third of current documentation is insufficient to submit ICD-10-CM claims. It's time to start building your knowledge base for ICD-10-CM transition by taking an A&P, medical terminology, or pathophysiology course. The more you know, the easier it will be to assign codes and work with your providers on documentation requirements.
IN THE NEWS
CMS ICD-9-CM C&M Meeting
The last CMS Coordination and Maintenance Committee Meeting was held on September 14, 2011. Topics for this meeting included: ICD-9-CM and ICD-10-CM partial code set freeze and new codes for ICD-9-CM and ICD-10-PCS. The Summary Report, Meeting Materials, and Meeting Audio are available for review.
PREOPERATIVE DIAGNOSIS: Low back pain and lumbar radiculopathy secondary to a herniated nuclear pulposus at L5-S1
POSTOPERATIVE DIAGNOSIS: Same
PROCEDURE PERFORMED: The patient presents for left transforaminal epidural injection at L5-S1
DESCRIPTION OF PROCEDURE: Patient was interviewed, consented. Patient was then brought to the treatment room in prone position. Betadine prep was done. Fluoroscopy was used at 15 degree oblique angle to open up the area for selective nerve block on the left side at L5-S1. A 25 gauge needle was utilized with 1% lidocaine with localization. Skin wheal was done followed by 3-1/2 inch 20 gauge spinal needle, utilized in an oblique angle. It was advanced. Lateral view was also checked and the needle was in the L5-S1 left neural foramen. At that time there was negative aspiration and 0.5 mL of Omnipaque dye was injected followed by an injection with 1.5 mL of 0.25% bupivacaine with 4 mg of Kenalog. Patient tolerated procedure. Patient was then brought to recovery in satisfactory condition. Patient will follow up in 7-10 days.
ICD-10-CM Code: M51.17 Intervertebral disc disorders with radiculopathy, lumbosacral region
Rationale: In ICD-10-CM a combination code exists to show the disc disorder with radiculopathy. However, the low back pain would not be reported as it is a common side effect of the disc displacement.
ICD-10 Implementation Strategies
We will be sharing a number of strategies to help your practice successfully implement ICD-10-CM. Please remember to track your progress in your ICD-10 Implementation Tracker on AAPC's website.
The Go-Live date for 5010 is only months away. Now is the time to ensure that the transition is going smoothly for the January 1, 2012 deadline. If you are vendor dependent for 5010 make sure to check in with them and see if anything is needed. If you are handling 5010 conversion internally, check with your IT department and make sure that testing is going according to plan. As of January 1, 2012, electronic transactions that do not use Version 5010 are not compliant with HIPAA and will be rejected. To allow time for testing, CMS began accepting electronic transactions using either Version 4010/4010A or Version 5010 standards on January 1 and will continue to through December 31, 2011.
Looking for articles on ICD-10 to help raise awareness in your clinic? Or want to find out what is going on regarding ICD-10 in the health care community? Take a look at AAPC's ICD-10 News and Articles to get the latest information on ICD-10.