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ICD-10 Discussion

  1. Default
    Medical Coding Books
    I was under the impression that all other countries are using ICD10

  2. Cool I am both apprehensive and excited!
    I am both apprehensive and excited!
    As a woman of a certain age who has only been in this industry for a total of 5 years and certified for only 2 of those 5.
    I see this an excellent opportunity...any new coders out there should start educating themselves NOW!
    I suspect there will be many veteran coders and physicians who will have a very difficult time with the transition.
    My only problem at this point is, where do I start!???
    Does anyone have a insite or advice??
    Thanks, June

  3. #33
    Swainsboro/Statesboro, GA
    Default ICD-10 Info
    CMS has a lot of information about ICD-10 on their website, as does AHIMA.

    Try these links:

  4. #34
    I am excited about ICD-10-CM, I code for Bariatric Surgerons and I would love to be able to code more specifically so I won't have so many denials.

  5. Default Icd-10
    Here's a summary of the Final Rule that I put together to explain ICD-10 to myself. That being said, I am going to have someone like Deb Grider teach me the details before 2013!!

    Final Rule: ICD -10 and ICD-10 PCS

    Current Code Sets: Maintained and distributed by DHHS

    About ICD-9-CM:

    • The International Classification of Diseases (ICD) codes were developed and maintained by the World Health Organization (WHO) in the 60s to classify causes of death (mortality). The goal was to make sure that diseases (such as small pox, malaria and polio) have the same meaning and application from country to country. The Morbidity component was added to subsequent revisions.

    • US and other countries adopted ICD and added clinical modifications (CM's) to meet the needs of their respective health care systems.

    • ICD-9 was adopted by US in 1979 for morbidity applications and was adopted as a HIPAA standard in 2000.

    • Updates: ICD-9 codes are updated twice a year. New codes are added to accommodate new technology and more sophisticated diagnoses and treatment of clinical conditions.

    • International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), Volumes 1 and 2 for coding diseases, injuries, impairments, and other health problems. Approximately 13,000 codes

    • ICD-9-CM, Ninth Revision, Volume 3 for coding procedures on hospital inpatients. Approximately 3,000 codes

    • ICD-9-CM Volumes 1, 2 and 3 were already widely used in administrative transactions when HIPAA rule promulgated.

    About ICD-10 Codes:

    • Developed by WHO in 1989.

    • National Center for Health Statistics (NCHS) developed ICD-10 CM (early 1990's), followed by CMS developing ICD-10 PCS thereafter.

    • International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). Code set for diagnosis. Approximately 68,000 codes.

    • International Classification of Diseases, Tenth Revision, Procedural Coding System (ICD-10 PCS). Code set for inpatient hospital procedures. Approximately 87,000 codes

    Compliance Date: October 1, 2013.

    What's the difference between 9 and 10?

    • ICD-9 codes are three to five digits long and organized into chapters by body system, i.e. digestive, musculoskeletal, and respiratory. This code set was never designed to provide for an increased level of detail needed to support emerging needs, such as bio-surveillance or pay for performance. Limited digit and categories means limited functionality given evolving complexity of health care services and diagnoses. Many chapters of ICD-9 are full.

    • ICD-10 codes are three to seven alpha-numeric characters. ICD-10 arranges diseases according to an axis of classification based on etiology, anatomy, or severity with anatomy being the primary axis.

    • ICD-9: Approximately 16,000 diagnosis and procedure codes

    • ICD-10: Approximately 155,000 diagnosis and procedures codes.

    Note, moving from ICD-9 to ICD-10 is not merely adopting a revised version. This represents a complete change from one coding system to a new one that is structured in a completely different way.

    Why are we doing this? – Lack of Space for new procedures and conditions.

    1. Its just plain old!

    • ICD-9 codes set were established in 1979. Numerous ICD-9 procedure codes are based upon technology that is now outdated.

    • Not only that, it's running out of space for new codes. New and changing medical advancements, including sophistication in diagnosis and disease management as well as technological advances in medicine over the past 29 years has increasingly made the ICD-9 code set unworkable in terms of responding to additional classifications or accommodating newly identified diseases or medical advances.

    • To accommodate changes, additions or workarounds have been added over the years. As above, the current ICD-9 coding hierarchy is running out of room. New codes are being assigned to topically unrelated chapters as a workaround, but this creates the opportunity for significant error rates in coding for both reimbursement and information tracking purposes.

    • The American Hospital Association (AHA) has estimated that the ICD-9 code set will run out room for addition of diagnosis and procedure codes in 2009.

    • By way of example, at present there are approximately 3,000 ICD-9 codes for procedures. Of the approximately 20 million procedures performed each year, roughly one percent or 200,000 are new.

    2. Lack of Detail:

    • Again, think of 1979. The ICD-9 codes are just not accurate enough for today's health care environment.

    • The new ICD-10 codes provide more information and detail within the codes than ICD-9 facilitating timely claims payment and fewer requests for additional information. Additional improvements include:
    i. Coding primary care encounters, external causes of injury, mental disorders, neoplasms, and preventative health;
    ii. Advances in medicine and medical technology;
    iii. Coding detail on socioeconomic, family relationships, ambulatory care conditions, lifestyle related problems, and screening test results;
    iv. More space to accommodate future expansions;
    v. New categories for post-procedural disorders;
    vi. Additional of laterality- i.e., specifying organ or body part involved;
    vii. Expanded distinctions for ambulatory care or managed care encounters.

    • Think of the fact that the Diagnosis-Related-Group (DRG) payment system classifies hospital cases into groups that are based on diagnosis, procedures, age, sex, and the presence of complications and co-morbidities and you can understand why CMS is doing this.

    • ICD-10 will allow the use of DRG definitions that better define new technologies and devices and offer greater specificity for clinical conditions. (Think of AIDS, SARS, Asian flu, etc.).

    • ICD-10 is also structured to expand to sufficiently accommodate future health care information.

    • ICD-10-PCS. Has no relationship to basic ICD-10 developed by WHO. Developed by CMS to sufficiently describe complex medical procedures. This becomes increasingly important when assessing and tracking the quality of medical processes and outcomes and compiling health care statistics. Greater transparency as to what procedures are being performed in hospitals!


    • ICD-10 code sets will allow for accurate description of diagnoses and procedures that is critical for research, quality health care data monitoring, and cost containment. Accuracy will facilitate better payment in pay-for-performance (P4P) programs, because these programs required detailed coding of diagnoses and the procedures performed to treat specific conditions.

    • ICD-10 will provide for specific diagnosis and treatment information that can improve quality measurements and patient safety, as well as better evaluation of medical processes and outcomes. This means meaningful clinical outcome information, more accurate health grades, and again, improved quality of care.

    • As we become a more global community, accuracy and cross-transparency of our health data in terms of medical conditions and technologies is vital. This is especially true in terms of biosurveillance, ie monitoring for Severe Acute Respiratory Syndrome (SARS), Asian bird flu or similar illnesses.

    • CMS estimates the costs for implementing ICD-10-CM and ICD-10-PCS will be offset by the benefits within four years of implementation.

    Any trend setters?

    • The ICD-9 diagnosis code set is no longer maintained by WHO. Everyone one else got on the ICD-10 bandwagon a long time ago.

    • The US is the only G-7 nation not using ICD-10. Canada, France, Germany, Great Britain, Italy and Japan adopted ICD-10 years ago.

    • The US adopted the ICD-10 for mortality reporting only in 1999. (Done by the CDC).

    • As of October 2002, 138 countries have adopted ICD-10 for coding and reporting mortality data, and 99 countries have adopted ICD-10 or a clinical modification for coding and reporting morbidity data.

    The future?

    WHO is currently working on ICD-11. This will not be available until 2020. ICD-11 will build upon ICD-10.

    What else?

    • CMS characterizes ICD-10 adoption as a β€œsignificant undertaking.” That's an understatement. Adoption and implementation will be similar to our activities involving Y2K compliance. But we can do it!

    • Watch for CMS FAQ's, fact sheets, and other supporting education and outreach materials.

    • All hipaa covered entities are affected by these rules. Covered entities include all health plans, health care clearing houses, health care providers that transmit electronic health information

  6. #36
    Hamden, CT
    Smile Embrace the inevitable
    We have been far behind for many years, and yes other countries are using ICD-11 already I do believe. And maybe they should just get us caught up instead!? Change is inevitable in this industry, once we are trained and know more it will be MUCH easier from what I have seen and researched on it. Much more specific, lot's more codes to remember but in the long run, it will be beneficial to everyone. It is a scary process to have to re-educate not just ourselves but our physcians as well, it will be costly and time-consuming, but the end result should be good. So we need to just bear down and join the band wagon and try to embrace this "monsterous" thing we have all been waiting years for!!! that is what I like about is a never-ending educational experience, but we can all rely on each other to learn more from!

  7. #37
    Kingsport, TN
    If you will look at the "Final Rule" on page 3332 it states ICD-11 has not yet been implemented and is based on the alpha numeric structure of the ICD-10 which would make the transition more complex and possibly more cost for all involved. I agree with the final rule but I also understand what everyone is saying about just starting with ICD-11 but that won't be available until 2014 and according to the final rule, ICD-9 is quickly running out of options for new codes for the evolving technologies, etc... So can we wait until 2014? Just my view.

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