ICD-10 Code Sets and Health Care

Remember, ICD-9-CM was implemented and in use since 1979, so updating terminology and new classifications were also changed with the upgrade of ICD-10-CM/PCS.

21 DIAGNOSIS OR NATURE OF THE ILLNESS OR INJURY - Enter the applicable ICD indicator to identify which version of ICD codes is being reported. Enter the indicator between the vertical, dotted lines in the upper right-hand portion of the field.

As you can imagine, ICD-10 codes allow for far greater specificity in clinical documentation. For example, the old ICD-9 system did not address laterality nor the episode of care. The old system also lacks other clinical specificities. For example, ICD-9 had one single code for a closed fracture of the femur (821.01) whereas ICD-10 will have at least 24 codes dealing with these kinds of

The continue use of ICD-9 codes after the effective date could result in the denial of reimbursement claims. This task can be assigned to the healthcare organization’s management team to determine a solution avoiding a break down in the system. Rahmathulla states, “In instances of an audit, appropriate documentation will make the query process substantially easier while enabling coders to clarify issues without having to query the provider multiple times for answers” (“Migration To The ICD-10 Coding System S187). It is important to accurately document to reduce the amount of claim denials. With the new specificity requirement of the ICD-10 and documentation supporting a claim, lowers the chances of healthcare fraud. The healthcare management team will oversee the process to prevent the risk of exposure.

All three of the parties have an interest in ICD-10 codes. They all have to use the updated version of ICD-10 codes, for the fact, it is an medical guideline by the government. The ICD-10 codes are easier to use than writing out the full medical term. They have over ten thousand codes, they can range from weird codes to normal

The main and most obvious difference between ICD-9 and ICD-10 is that there is a significant increase in the amount of codes. ICD-9-CM has an approximate of 17,849 codes when combining all procedural and diagnosis codes, whereas ICD-10 has well over 68,000 Clinical Modification (CM) codes and over 71,000 Procedural Coding System (PCS) codes. There are also several structural differences between ICD-9-CM and ICD-10-CM/PCS. Some of them are:

The International Classification of Diseases, Tenth Revision (ICD-10) has been in development since 1983 to replace the outdated Ninth Revision (ICD-9) that has been in use in the U.S. for over 35 years (Giannangelo, 2015). Due to the Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification regulation published in 2009, the Clinical Modification (ICD-10-CM) will replace ICD-9-CM Volumes 1 and 2, and the Procedure Coding System (ICD-10-PCS) will replace ICD-9-CM Volume 3 for all HIPAA transactions effective October 2015 (Giannangelo, 2015). These new code sets accommodate new procedures and diagnoses and allow for greater specificity in clinical documentation (Centers for Medicare & Medicaid Services [CMS],

The definition of ICD-10 diagnosis codes are a tool that groups and identifies diseases, disorders, symptoms poisonings, adverse effects of drugs and chemicals, injuries, and many other reasons for

ICD-10 – CM is a three- to seven character alphanumeric representation of a disease or condition. The first digit is alpha; Digit 2 is numeric. There is a decimal placed after the third character. There are 69,000 codes to better capture specificity, tis also

The Centers for Medicare and Medicaid Services (CMS) requires all providers to implement ICD-10 coding system begin on October 1st, 2015 so the U.S. healthcare system can communicate in the same language as with other countries’ systems. The transition from ICD-9 to ICD-10 had big changes from 14,000 diagnostic codes to more than 68,000 and 4,000 procedure codes to 87,000. The transition affected the reimbursements of hospitals. Medicare requires all patients’ procedures and services to be coded using ICD-10 system while they are charged in CDM using CPT codes. However, there is no direct link between ICD and CPT codes (Jensen, Ward, & Starbuck, 2016). The CDM committee had to work together to prepare for this event. Switching from numerical

Switching ICD-9 to ICD-10-CM is going to make a huge difference in the medical field! The switch to ICD-10-CM will help with cost reductions, improve quality of care for patients and update the healthcare data the way it should be. One of the major impacts of the switch would be that ICD-10-CM has 65,000 new codes that ICD-9 didn’t have. Having that many more codes means that the detail in each code will be extremely precise and there would be no question on a person diagnosis. The codes are mainly to classify a disease or someones’ major health problem. With ICD-10-CM new codes, they can become precise enough to identify diseases and produces that we were not able to in ICD-9. This is an awesome, huge step in the medical field!

In 1978, the World Health Organization published ICD-9. It was later modified by the US Public Health Service so that it could service the needs of American hospitals. This modification was named International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM). As of October 1, 2015, ICD-9-CM was replaced with ICD-10-CM. ICD-10-CM was considered an upgrade from ICD-9-CM because it was more specific and contained many more codes than its predecessor. Most of the categories contained in ICD-9-CM were completely full with no room for expansion. ICD-10-CM goes into a lot more detail than ICD-9-CM. ICD-10 has been upgraded to contain up to seven digits as opposed to the four to five that were associated with ICD-9.

As necessary as ICD-10 is, smaller practices that only have a few physicians on staff will have more of a difficult time integrating the system than larger organizations. The reason being that larger healthcare organizations tend to have coders. Coders are individuals who hardly ever have contact with patients but they are important in the sense that they are the ones that input the ICD codes into patients’ medical records. Without coders, physicians would have to be the ones to input the ICD codes into the patients’ medical record. Luckily physicians at hospitals and other large health organizations do not need to do this. Unfortunately, physicians at smaller organizations do not have coders at their disposal and they are the ones that enter the ICD codes.

Number of codes: ICD-9 has 17,000 diagnostic codes and almost 4,000 procedure codes. In contrast, ICD-10 70,000 diagnostic codes (clinical modification codes) and more than 72,000 procedure codes.

The compliance date for implementation of the International Classification of Diseases, 10th Edition, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) was October 1, 2013 for all covered entities. Although, a number of countries that have already converted to ICD-10: