What Are The Standardized Code Sets?

"In the United States, ICD-10 has been used to classify mortality data since 1999, while we continue to use ICD-9-CM for all other purposes, such as billing and morbidity statistics. In addition, government agencies, health care insures, and providers are studying the implications of switching to ICD-10-CM." (Aalseth, 2006)

Coding systems are used in the inpatient and outpatient settings for the classification of patient morbidity and mortality information for statistical use. The World Health Organization (WHO) developed the Ninth Revision, International Classification of Diseases (ICD-9) in the 1970s to track mortality statistics across the world. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), is the adaptation the U.S. health system uses as a standard list of six-character alphanumeric codes to describe diagnoses. Globally utilizing a standardized system improves consistency in recording symptoms and diagnoses for payer claims reimbursement, as well as clinical research, and tracking purposes.

16. If a patient were discharged from the hospital with a diagnosis of probable myocardial infraction without a history of MI in the past, what ICD-9 code would the document for this stay?

To make life easier you should document these patients with both ICD-9 and ICD-10 from the getgo. By entering all of your patient’s insurance information into your billing system, it will prompt you to enter both code sets at the beginning of treatment enabling a smooth transition to a patient’s secondary insurance once his primary benefits have been exhausted.

Enter the 3-5 alpha/numeric character code from the ICD-9 related to the procedures, services, or supplies listed in Block #24e. List the primary diagnosis on Line A, with any subsequent codes to be entered on Lines B thru H (the highest level of specificity in priority order). Additional diagnoses are optional and may be listed on Lines I thru L. – Required

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.

I am choosing ICD-10 Codes. The reason I have chosen ICD-10 codes is because every medical facility uses the ICD-10 codes for the billing and coding. That is the only way they get paid is by using ICD-10 codes. They will all receive adequate payments using the updated codes and the right type of billing.

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:

- structure of procedure codes. Codes in ICD-10-PCS have 7 characters where each of them can be either alpha or numeric. Compare to ICD-9-CM, there are 3-4 characters where all characters are numeric.

C.The third and subsequent ; digits on this case for the ICD 10 Codes The third and subsequent can be alpha or numeric.But for the ICD 9,digits three through five were always numeric.

There are lots of similarities and differences between ICD-9 and ICD-10. You need to look up the terms in a coding manual, but the codes are all different. Both ICD-9 and ICD-10 code to the highest greatest level of specificity per the information provided. The ICD-9 codes were 3-5 digits where the ICD-10 codes are 5-7 digits in length. ICD-10 codes are more specific as to left or right, front or back where ICD-9 codes were not as specific. In ICD-10, an “X” is used as a placeholder

Due to ICD-9-CMS’ ability to provide necessary detail for patients’ medical conditions or the procedures and services performed on hospital patients, ICD-10-CM/PCS was implemented.

ICD-10, which is the tenth revision of the International Statistical Classification of Diseases and Related Health Problem, refers to a medical classification inventory for the coding of diseases, their signs, symptoms and causes (Center for Disease Control and Prevention 1). The use of this revised version in the United States is scheduled to begin officially on the first of October 2013. Currently, ICD-10 is being used for diagnosis coding, in procedure coding systems and for inpatient procedure coding.

It is very difficult to adequately represent some of the ICD coding conventions for a computer’s purposes. The codes produced by the crossmap will need to be evaluated in the context of the complete medical record and applicable reporting rules and compensation requirements before being submitted to payers and other external entities. The construct, greater specificity, and representation of modern clinical medicine provided by ICD-10-CM and ICD-10-PCS will greatly facilitate the computerized generation of ICD codes ultimately anticipated in an EHR

The outmoded coding professional’s role was to describe and apportion diagnosis, procedure, and other medicinal service codes using ICD-9-CM and HCPCS/CPT coding classifications while referencing the Coding Clinic for ICD-9-CM, Coding Clinic for HCPCS,