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WASHINGTON The upcoming ICD-10 diagnosis and procedure coding system is more complicated than its predecessor, ICD-9, but it will allow for a greater level of clinical detail and will be better able to keep up with advances in technology, according to several speakers at a meeting sponsored by the American Health Information Management Association.
"ICD-9 badly needs to be replaced," said Nelly Leon-Chisen, director of coding and classification at the American Hospital Association. "It's 30 years old, and the terminology and classification of some conditions are obsolete."
There are two parts to ICD-10, formally known as the International Classification of Diseases, 10th revision, which goes into effect in the United States on Oct. 1, 2013: ICD-10-CM, which is the clinical modification of the World Health Organization's ICD-10 diagnostic coding system; and ICD-10-PCS, an inpatient procedural coding system developed under contract to the Centers for Medicare and Medicaid Services.
ICD-10 "will have better data for evaluating and improving quality of care. It will provide codes for a more complete picture," she added, noting that the new code set will allow health officials to be "better able to track and respond to global health threats."
Because ICD-10 can more precisely document diagnoses and procedures, it will bring better justification of medical necessity for billing purposes, "but not from day 1," said Ms. Leon-Chisen. "It will take a little while" for people to adjust to the new codes. The new system also may reduce opportunities for fraud, she added.
Ms. Leon-Chisen outlined a few basic differences between ICD-9 and ICD-10 diagnosis codes:
P ICD-9 codes contain 35 characters, whereas ICD-10 contains 37 characters.
P With ICD-9 codes, the first character can be alphabetic or numeric, but in ICD-10, the first character is always alphabetic.
P ICD-10 codes can include the use of a placeholder "x," whereas ICD-9 codes cannot.
She also gave an example, showing the differences between the two revisions. Under the ICD-9 coding system, a patient with a pressure ulcer on the right buttock might receive a diagnosis code of 707.05, "pressure ulcer, buttock."
Under ICD-10, the same patient would get L89.111, "decubitus ulcer of right buttock limited to breakdown of the skin." A pressure ulcer on the left buttock or a more severe one including necrosis of the bone would get a different ICD-10 code.
Sue Bowman, director of coding policy and compliance for the American Health Information Management Association, noted that ICD-10-PCS can have even more complexities. For example, under ICD-9, there is only one code for artery repair; under ICD-10-PCS, there are 276 codes. However, "once you work with it, you're struck by the logic of the system," she said. "It's really not that difficult." Under the ICD-10 code structure, each character has a specific meaning.
Ms. Bowman pointed out some of the differences between procedure codes under the two revisions. For example, ICD-9 procedure codes have 34 characters, whereas ICD-10-PCS codes always have 7 characters.
Also, all ICD-9 procedure code characters are numeric, whereas ICD-10-PCS code characters can each be alphabetic or numeric; alphabetic characters are not case sensitive.
As an example of the difference in procedure codes, she cited the ICD-9 code 17.43 for "percutaneous robotic assisted procedure," versus 8E093CZ, the ICD-10-PCS code for "robotic assisted procedure of head and neck region, percutaneous approach."
One issue that Medicare officials and others dealing with ICD-10 are wrangling with, Ms. Bowman noted, is whenor whetherboth ICD-9 and ICD-10 should be "frozen"that is, when no more new codes should be added to either code set so that they will be stable while people are making the changeover from ICD-9 to ICD-10. Both code sets are currently updated annually, she said.
The move to the new code sets was necessary, according to Department of Health and Human Services to replace the outdated ICD-9 code sets. The ICD-9-CM contains about 17,000 codes, compared with 155,000 codes in the ICD-10 code sets.
ICD-9 needs to be replaced. 'It's 30 years old, and the terminology and classification of some conditions are obsolete.' MS. LEON-CHISEN
Recommended ICD-10 Resources
Ms. Bowman recommended the following resources for physicians interested in obtaining more in-depth information about ICD-10:
National Center for Health Statistics/Centers for Disease Control and Prevention: Information about new disease classifications
www.cdc.gov/nchs/about/otheract/icd9/abticd10.htm
Centers for Medicare and Medicaid Service: ICD-10 Overview
The American Hospital Association: ICD-10 Resource Center
www.ahacentraloffice.com/ahacentraloffice_app/ICD-10/ICD-10.jsp
American Health Information Management Association: Newsletter sign-up and other information
WASHINGTON The upcoming ICD-10 diagnosis and procedure coding system is more complicated than its predecessor, ICD-9, but it will allow for a greater level of clinical detail and will be better able to keep up with advances in technology, according to several speakers at a meeting sponsored by the American Health Information Management Association.
"ICD-9 badly needs to be replaced," said Nelly Leon-Chisen, director of coding and classification at the American Hospital Association. "It's 30 years old, and the terminology and classification of some conditions are obsolete."
There are two parts to ICD-10, formally known as the International Classification of Diseases, 10th revision, which goes into effect in the United States on Oct. 1, 2013: ICD-10-CM, which is the clinical modification of the World Health Organization's ICD-10 diagnostic coding system; and ICD-10-PCS, an inpatient procedural coding system developed under contract to the Centers for Medicare and Medicaid Services.
ICD-10 "will have better data for evaluating and improving quality of care. It will provide codes for a more complete picture," she added, noting that the new code set will allow health officials to be "better able to track and respond to global health threats."
Because ICD-10 can more precisely document diagnoses and procedures, it will bring better justification of medical necessity for billing purposes, "but not from day 1," said Ms. Leon-Chisen. "It will take a little while" for people to adjust to the new codes. The new system also may reduce opportunities for fraud, she added.
Ms. Leon-Chisen outlined a few basic differences between ICD-9 and ICD-10 diagnosis codes:
P ICD-9 codes contain 35 characters, whereas ICD-10 contains 37 characters.
P With ICD-9 codes, the first character can be alphabetic or numeric, but in ICD-10, the first character is always alphabetic.
P ICD-10 codes can include the use of a placeholder "x," whereas ICD-9 codes cannot.
She also gave an example, showing the differences between the two revisions. Under the ICD-9 coding system, a patient with a pressure ulcer on the right buttock might receive a diagnosis code of 707.05, "pressure ulcer, buttock."
Under ICD-10, the same patient would get L89.111, "decubitus ulcer of right buttock limited to breakdown of the skin." A pressure ulcer on the left buttock or a more severe one including necrosis of the bone would get a different ICD-10 code.
Sue Bowman, director of coding policy and compliance for the American Health Information Management Association, noted that ICD-10-PCS can have even more complexities. For example, under ICD-9, there is only one code for artery repair; under ICD-10-PCS, there are 276 codes. However, "once you work with it, you're struck by the logic of the system," she said. "It's really not that difficult." Under the ICD-10 code structure, each character has a specific meaning.
Ms. Bowman pointed out some of the differences between procedure codes under the two revisions. For example, ICD-9 procedure codes have 34 characters, whereas ICD-10-PCS codes always have 7 characters.
Also, all ICD-9 procedure code characters are numeric, whereas ICD-10-PCS code characters can each be alphabetic or numeric; alphabetic characters are not case sensitive.
As an example of the difference in procedure codes, she cited the ICD-9 code 17.43 for "percutaneous robotic assisted procedure," versus 8E093CZ, the ICD-10-PCS code for "robotic assisted procedure of head and neck region, percutaneous approach."
One issue that Medicare officials and others dealing with ICD-10 are wrangling with, Ms. Bowman noted, is whenor whetherboth ICD-9 and ICD-10 should be "frozen"that is, when no more new codes should be added to either code set so that they will be stable while people are making the changeover from ICD-9 to ICD-10. Both code sets are currently updated annually, she said.
The move to the new code sets was necessary, according to Department of Health and Human Services to replace the outdated ICD-9 code sets. The ICD-9-CM contains about 17,000 codes, compared with 155,000 codes in the ICD-10 code sets.
ICD-9 needs to be replaced. 'It's 30 years old, and the terminology and classification of some conditions are obsolete.' MS. LEON-CHISEN
Recommended ICD-10 Resources
Ms. Bowman recommended the following resources for physicians interested in obtaining more in-depth information about ICD-10:
National Center for Health Statistics/Centers for Disease Control and Prevention: Information about new disease classifications
www.cdc.gov/nchs/about/otheract/icd9/abticd10.htm
Centers for Medicare and Medicaid Service: ICD-10 Overview
The American Hospital Association: ICD-10 Resource Center
www.ahacentraloffice.com/ahacentraloffice_app/ICD-10/ICD-10.jsp
American Health Information Management Association: Newsletter sign-up and other information
WASHINGTON The upcoming ICD-10 diagnosis and procedure coding system is more complicated than its predecessor, ICD-9, but it will allow for a greater level of clinical detail and will be better able to keep up with advances in technology, according to several speakers at a meeting sponsored by the American Health Information Management Association.
"ICD-9 badly needs to be replaced," said Nelly Leon-Chisen, director of coding and classification at the American Hospital Association. "It's 30 years old, and the terminology and classification of some conditions are obsolete."
There are two parts to ICD-10, formally known as the International Classification of Diseases, 10th revision, which goes into effect in the United States on Oct. 1, 2013: ICD-10-CM, which is the clinical modification of the World Health Organization's ICD-10 diagnostic coding system; and ICD-10-PCS, an inpatient procedural coding system developed under contract to the Centers for Medicare and Medicaid Services.
ICD-10 "will have better data for evaluating and improving quality of care. It will provide codes for a more complete picture," she added, noting that the new code set will allow health officials to be "better able to track and respond to global health threats."
Because ICD-10 can more precisely document diagnoses and procedures, it will bring better justification of medical necessity for billing purposes, "but not from day 1," said Ms. Leon-Chisen. "It will take a little while" for people to adjust to the new codes. The new system also may reduce opportunities for fraud, she added.
Ms. Leon-Chisen outlined a few basic differences between ICD-9 and ICD-10 diagnosis codes:
P ICD-9 codes contain 35 characters, whereas ICD-10 contains 37 characters.
P With ICD-9 codes, the first character can be alphabetic or numeric, but in ICD-10, the first character is always alphabetic.
P ICD-10 codes can include the use of a placeholder "x," whereas ICD-9 codes cannot.
She also gave an example, showing the differences between the two revisions. Under the ICD-9 coding system, a patient with a pressure ulcer on the right buttock might receive a diagnosis code of 707.05, "pressure ulcer, buttock."
Under ICD-10, the same patient would get L89.111, "decubitus ulcer of right buttock limited to breakdown of the skin." A pressure ulcer on the left buttock or a more severe one including necrosis of the bone would get a different ICD-10 code.
Sue Bowman, director of coding policy and compliance for the American Health Information Management Association, noted that ICD-10-PCS can have even more complexities. For example, under ICD-9, there is only one code for artery repair; under ICD-10-PCS, there are 276 codes. However, "once you work with it, you're struck by the logic of the system," she said. "It's really not that difficult." Under the ICD-10 code structure, each character has a specific meaning.
Ms. Bowman pointed out some of the differences between procedure codes under the two revisions. For example, ICD-9 procedure codes have 34 characters, whereas ICD-10-PCS codes always have 7 characters.
Also, all ICD-9 procedure code characters are numeric, whereas ICD-10-PCS code characters can each be alphabetic or numeric; alphabetic characters are not case sensitive.
As an example of the difference in procedure codes, she cited the ICD-9 code 17.43 for "percutaneous robotic assisted procedure," versus 8E093CZ, the ICD-10-PCS code for "robotic assisted procedure of head and neck region, percutaneous approach."
One issue that Medicare officials and others dealing with ICD-10 are wrangling with, Ms. Bowman noted, is whenor whetherboth ICD-9 and ICD-10 should be "frozen"that is, when no more new codes should be added to either code set so that they will be stable while people are making the changeover from ICD-9 to ICD-10. Both code sets are currently updated annually, she said.
The move to the new code sets was necessary, according to Department of Health and Human Services to replace the outdated ICD-9 code sets. The ICD-9-CM contains about 17,000 codes, compared with 155,000 codes in the ICD-10 code sets.
ICD-9 needs to be replaced. 'It's 30 years old, and the terminology and classification of some conditions are obsolete.' MS. LEON-CHISEN
Recommended ICD-10 Resources
Ms. Bowman recommended the following resources for physicians interested in obtaining more in-depth information about ICD-10:
National Center for Health Statistics/Centers for Disease Control and Prevention: Information about new disease classifications
www.cdc.gov/nchs/about/otheract/icd9/abticd10.htm
Centers for Medicare and Medicaid Service: ICD-10 Overview
The American Hospital Association: ICD-10 Resource Center
www.ahacentraloffice.com/ahacentraloffice_app/ICD-10/ICD-10.jsp
American Health Information Management Association: Newsletter sign-up and other information