ICD-10 Back to the Basics

This year, I’d venture to say most providers had a happy Valentine’s Day for one reason or another. On February 14, Health and Human Services Secretary Kathleen Sebelius announced the plan to delay the projected ICD-10 compliance date of October 2013. Providers across the US released a sigh of relief! Sebelius stood by the claim that ICD-10 will improve patient care and enable health care data exchange with the rest of the world—who has already been using ICD-10 for some time.

So what is ICD-10?

• International Classification of Diseases, 10th Edition diagnosis and procedure codes
• ICD-10 completed in 1992
• More than 155,000 codes
• About 25 countries currently use ICD-10
• The length of codes in ICD-10 being a maximum of 7 characters, as opposed to 5 digits in ICD-9

Why transition to ICD-10?

• ICD-10 contains increased specificity which will lead to:
• More accurate and timely reimbursements once the system is fully implemented
• Increased measurability of quality, safety, and efficacy of care
• Setting informed health policy
• Monitoring resource utilization
• Improving disease and care management

What do we need to know about ICD-10?

• Although eventually we will need to know basically everything about ICD-10, the following is a high-level look at the new coding system:
• Contains over 155,000 codes
• Maximum code length increased to 7 characters with dummy place holders to allow room for expansion
• Requires crosswalk mapping between ICD-9 and ICD-10 codes and vice versa because the systems are not related in a one-to-one relationship. CMS has released General Equivalence Mappings and Reimbursement Maps to help with this process.
• Departments will need to run both ICD-9 and ICD-10 codes concurrently during transition period until all claims are resolved
• All systems will be affected!

Although the implementation date has been delayed, the eventual transition to ICD-10 is inevitable. In addition, other government regulations will be continuing to grow more rigorous—stage 2 of EHR Meaningful Use is already out! To reduce the loss of productivity, begin working on the transition now. Start with assessing the areas in your practice which will be affected by the change.