Is the Thought of Implementing ICD-10 Depressing?

Does the thought of all the planning and analysis that must be accomplished prior to ICD-10 implementation cause you to slump into a major depressive state?   Has it only occurred once or does the condition reoccur frequently?  Is it mild, moderate or severe?  Do you have psychotic symptoms, and if yes, what are they?  If you have answered yes to any of these questions, you are not alone.  ICD-10 implementation will be challenging, but we can turn it into a positive and have fun with it as well.  Let’s look at coding this scenario using ICD-10-CM.

Today is September 1, 2009.  Mary Pleaser, a 45-year-old CPC coder/manager who is responsible for ICD-10-CM implementation in a 25-physician practice, is in a major depressive state.  This has been on-going ever since she heard about the ICD-10 final rule in January.  This past week the depression went from mild to moderate, and if she does not get some help, the depression may become severe. Her physicians have indicated that she can conduct all the steps to implement ICD-10-CM alone.  Her boss, Dr. Bob, stated “The AAPC gave you the ICD-10 tracker, and you listened to the webinars; is that not enough?”  “No,” declared Mary.  “I need some help here. We went over the steps, Dr. Bob, but it will take a team and one of the experienced AAPC Trainers to train us on how to implement ICD-10.  I really, really need the AAPC’s help.”  “Well Mary,” Dr. Bob said thoughtfully. “If the three-day training can be on-site at the right price with the right curriculum and at the right time, I think we can all benefit from attending and maybe make this transition much easier for all of us.  What do you think?”  “Oh thank you, Dr. Bob,” exclaimed Mary.  “This will truly put me on the road to recovery quickly so we can get this new coding system implemented on time.”

Now let’s code Mary’s current condition using ICD-10-CM

Mental and behavioral disorders are located in Chapter 5 of ICD-10-CM

Mood (affective) disorders are coded in category F30-F39

Major depression is coded in category F32-F33

Major depression for a singe episode is coded as F32.-

Major depression for a recurrent episode is coded as F33.-

This is how Mary’s condition is coded using ICD-10-CM

She is in a major depressive state which is recurrent                                F33

Her depression which was previously mild is now moderate                     F33.1

The correct ICD-10-CM code is F33.1

Tip:  When an ICD-10-CM code requires additional characters, it is reported using a dash (-) after the decimal.

By Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CEMC, COBGC, CPCD, CCS-P
Vice President, Strategic Development
American Academy of Professional Coders

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2 Responses to “Is the Thought of Implementing ICD-10 Depressing?”

  1. Lee K says:

    I think all of the materials that I have reviewed so far are very impressive. I’m certain that much study, thought, and work has accompanied these training materials and articles. Please continue to provide us with educational information and training materials to help us make this monumental transition!

  2. Jonathan Schmidt says:

    I know its been two months but reading this left me with a question. Namely it says “When an ICD-10-CM code requires additional characters, it is reported using a dash (-) after the decimal.”

    But the code shown had no dash after the decimal, so does that mean that you would only put the dash in if there are additional characters after the first number after the decimal? If so would the dash be directly after the decimal or after the character that comes directly after the decimal and before the additonal character after the decimal? Hope this question isn’t too confusing. As an example, let’s say the additional character is a “2.”

    Would the code look like this?: F33.-12

    Or like this?: F33.1-2

    On a semi-related note, with so many more codes won’t the ICD10 books have to be much longer and have more volumes than the ICD9 books? Would the massive increase in code numbers include a equally massive price increase?

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