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Issue #3 - September 8, 2010
AAPC ICD-10 Newsletter


Featured Article
In the News
Coding Snapshot
I-10 Tips
ICD-10 Resource

Moving to ICD-10 CM/PCS will require a tremendous effort and incur incredible cost for health care organizations. Many health care organizations have not begun the implementation process and are expecting the date for implementation to be delayed. That is a misconception and could affect the health of the organization.

The countdown is now. Don't delay planning for implementation. The health of your organization depends on it!


AAPC and Ingenix have partnered to bring you 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.


Communicating With Physicians About ICD-10 Documentation

A question often asked at our boot camps is, “How do I get my physicians to document for ICD-10-CM?” This is probably one of the most challenging issues coders will face with the conversion to ICD-10-CM. Following are some tips based on these discussions with boot camp attendees.

First, talk with your physician regarding ICD-10 and its importance. If you have a large group of physicians, consider a PowerPoint presentation to keep everyone on track. Talk about the live date of October 1, 2013 and what the office needs to do to be ready. Stress the importance of the date and that there will be no delays in the implementation of the coding system. You can see all the steps needed on your ICD-10 Benchmark Tracker on our website.

Schedule regular meeting times for ICD-10 discussions. The frequency of these meetings should be driven by the size of the practice and the needs of the physicians. Perform audits specific to diagnosis. Code them first with ICD-9-CM, then code to ICD-10-CM. I suggest that you do these “audits” by disease process. For example, if you have a family practitioner group, start with diabetes. Pull notes for that diagnosis only. After doing the coding comparison, sit down with the doctors and discuss the differences between the systems using their own chart notes. Once they understand the diabetes set of codes, move on to hypertension and start the process again. This will allow for continuous education, but in a more focused manner. Just make sure to check back on the diagnoses that you already covered to ensure that your providers are keeping up with the documentation requirements.

These tips should help you formulate your game plan for documentation education.


CMS Announced C&M Committee Meeting to Discuss ICD-9 and ICD-10 Crosswalk Revisions
On-line registration opened on August 13, 2010 for the September 15-16, 2010 ICD-9-CM Coordination and Maintenance Committee meeting at:

Section 10109(c) of the Affordable Care Act (ACA) requires the Secretary of Health and Human Services (HHS) to task the C&M Committee to convene a meeting before January 1, 2011, to receive stakeholder input regarding the crosswalk between the Ninth and Tenth Revisions of the International Classification of Diseases (ICD-9 and ICD-10, respectively), posted to the CMS website at, for the purpose of making appropriate revisions to said crosswalk. Section 10109(c) further requires that any revised crosswalk be treated as a code set for which a standard has been adopted by the Secretary, and that revisions to this crosswalk be posted to the CMS website.

The C&M Committee will use the first half of the first day of the September C&M Committee meeting, 9:00 a.m. to 12:30 p.m. Wednesday, September 15, 2010, to fulfill the above-referenced PPACA requirements for this meeting to be held prior to January 1, 2011, and receive public input regarding the above-referenced crosswalk revisions. No other meeting will be convened by the C&M Committee for this purpose.


ASSESSMENT AND TREATMENT PLAN: Hypertension resistant to multiple medications as dictated above. The patient's history of blood pressure started at a very young age. No workup was done to rule out secondary hypertension. Will go ahead and order the (1) Plasma renin aldosterone ratio. (2) A 24 urine aldactone 18 glucuronide, tetrahydroaldosterone, free urine aldosterone. (3) Free serum metanephrine. (4) TSH. I will also order MRA to rule out renal artery stenosis. Meanwhile I gave the patient a prescription for Clonidine patch in addition to his current regimen 1 mg once a week. Will also go ahead and check the patient's urine tox screen because of previous past medical history.

Coded in ICD-9-CM 401.9

Coded in ICD-10-CM I10

Change in store for coders: In ICD-10-CM hypertension that is stated as either controlled or uncontrolled would be coded to I10.


ICD-10 is coming and the Department of Health and Human Services (HHS) is not going to delay implementation. We will be sharing a number of steps to help any practice successfully implement ICD-10-CM. They are also found in your ICD-10 Benchmark Tracker on AAPC's website.

Step #3: Conduct an Impact Analysis
An impact analysis will assist in determining the time requirements and budgetary concerns for the implementation process. A proper analysis should include regulatory requirements, timelines and resources. You'll also want to identify funding sources and a coordinator for the project.


ICD-10 will change everything in your office. Find out how you will be affected:

ICD-10 is expanding the code-set from 17,000 to 140,000 codes. AAPC's Code Translator tool can help you map that expansion. This resource uses CMS GEMS files to map ICD-9 codes to ICD-10 (and vice-versa). The Code Translator is also available for mobile devices.

Try It Now


ICD-10 Implementation in a 5010 Environment : Follow-up National Provider Call
The Centers for Medicare & Medicaid Services (CMS) will host a follow-up national provider conference call on "ICD-10 Implementation in a 5010 Environment". Subject matter experts will review basic information on both ICD-10 and 5010 and explain how they are interrelated. A question and answer session will follow the presentations.

When: Monday, September 13, 2010

Time: 12:00 p.m. - 1:30 p.m. ET

Target Audience: Medical coders, physician office staff, provider billing staff, health records staff, vendors, educators, system maintainers and all Medicare fee-for-service (FFS) providers



  • ICD-10 implementation for services provided on and after October 1, 2013
  • Differences between ICD-10 and ICD-9-CM codes
  • Differences between ICD-10 and ICD-9-CM codes
  • Tools for converting codes – General Equivalence Mappings (GEMs)
  • Proposal to freeze ICD-9-CM and ICD-10 code updates except for new technologies and diseases

HIPAA Version 5010

  • Compliance dates and timelines (No contingencies)
  • 5010 before and after ICD-10 Implementation
  • Readiness review for implementing HIPAA version 5010 and D.0
  • What you need to be doing to prepare (GEMs)
  • Medicare fee-for-service activities update
  • Other issues and considerations
Conference Call Registration Information:

Date: September 13, 2010

Conference Title: ICD-10 Implementation in a 5010 Environment Follow-Up National Provider Call

Time: 12:00 p.m. ET

In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation.

Registration will close at 12:00 p.m. ET on September 10, 2010, or when available space has been filled. No exceptions will be made, so please be sure to register early, prior to this time.

  1. To register for the call participants need to go to:
  2. Fill in all required data
  3. Verify that your time zone is displayed correctly in the drop down box.
  4. Click "Register."
  5. You will be taken to the "Thank you for registering" page and will receive a confirmation email shortly thereafter.

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