The 10th revision of the International Statistical Classification of Diseases by the World Health Organization (WHO), popularly known as “ICD-1o” is set for implementation by October 1, 2015. What this means is — all health care providers and payers must adopt to the new ICD-10 coding system effective by this date. And this relatively short “span of time” has made the healthcare industry, in particular, the smaller medical practices, feeling stressed and unprepared. A recent survey conducted by NueMD regarding preparedness shows that only 11 percent of the 1,000 respondents said they are “highly confident” about their ICD-10 knowledge.
Prepared or not prepared, October 1, 2015 is set for ICD 10 implementation. Thus, in this article, we’re going to give you important insights about ICD 10, tips and online ICD 10 training resources so you are ICD-10 ready before October 1.
What is Different with ICD-10?
From ICD-9 to ICD-10 — it is more than an update, it’s a leap in how we define care. It is important to understand the major improvements and changes between ICD-9 and ICD-10 diagnosis codes. See chart below as an example:
|ICD-9-CM Diagnosis Codes||ICD-10-CM Diagnosis Codes|
|No Laterality||Laterality –|
Right or Left account for >40% of codes
|3-5 digits||7 digits|
|No placeholder characters||“X” placeholders|
|14,000 codes||69,000 codes to better capture specificity|
|Limited Severity Parameters||Extensive Severity Parameters|
|Limited Combination Codes||Extensive Combination Codes to better capture complexity|
|1 type of Excludes Notes||2 types of Excludes Notes|
Source: ICD 10 Overview
Myths and Facts about ICD-10
MYTH: ICD-10-CM/PCS implementation planning should be undertaken with the assumption that the Department of Health and Human Services (HHS) will grant an extension beyond the October 1, 2015, compliance date.
FACT: All HIPAA-covered entities must implement the new code sets with dates of service, or date of discharge for inpatients, that occur on or after October 1, 2015. HHS has no plans to extend the compliance date for implementation of ICD-10-CM/PCS; therefore, covered entities should plan to complete the steps required to implement ICD-10-CM/PCS on October 1, 2015.
MYTH: Non-covered entities, which are not covered by HIPAA such as Workers’ Compensation and auto insurance companies, that use ICD-9-CM may choose not to implement ICD-10-CM/PCS.
FACT: Because ICD-9-CM will no longer be maintained after ICD-10-CM/PCS is implemented, it is in non-covered entities’ best interest to use the new coding system. The increased detail in ICD-10-CM/PCS is of significant value to non-covered entities. The Centers for Medicare & Medicaid Services (CMS) will work with non-covered entities to encourage them to use ICD-10-CM/PCS.
MYTH: State Medicaid Programs will not be required to update their systems to use ICD-10-CM/PCS codes.
FACT: HIPAA requires the development of one official list of national medical code sets. CMS will work with State Medicaid Programs to ensure that ICD-10-CM/PCS is implemented on time.
Source: ICD-10-CM/PCS MYTHS AND FACTS
Why Anatomy & Physiology (A&P) Knowledge Matters
With the transition from ICD-9 to ICD-10, the number of available codes will more than quadruple. All of these extra codes are designed to increase coding specificity, meaning more accurate reimbursements for healthcare providers. But there’s another factor to consider here too; the increased specificity will require a greater understanding of anatomy and physiology (A&P). ICD-10 codes are simply more complex – unfortunately, that’s the only “simple” part of this process. Each individual code may be comprised of up to 7 alphanumeric characters and 4 sections, so arriving at the proper code will be more involved and time-consuming.
For example, each code may contain the following sections:
Not only that, but looking up the codes in the ICD-10 Alphabetic Index will be different also. Take a peek at the video below to see how a broken wrist is coded in ICD-10. It really reinforces the importance of knowing A&P.
ICD-10 Training Preparations
In less than 3 months – on October 1, 2015 – you’ll be expected to begin billing with ICD-10 codes. Will your practice be ready?
A recent survey by NueMD found that only 69% of healthcare professionals were “ confident” in their abilities to be ICD-10 ready and 31% are still “not confident” by that date.
Fortunately, coders at Certification Coaching Organization (CCO) are ICD-10 certified and ready to walk your practice through the transition. Take a peek of our ICD 10 courses offered below and enjoy group discounts.