ICD-10 is the 10th edition of the International Classification of Diseases, a coding system endorsed and maintained by the World Health Organization and used internationally to store and retrieve diagnostic medical information and compile national mortality rates and statistics.
It has been used since 1993 in WHO member states, but the U.S. has only recently decided to switch from the ICD-9 coding system to ICD-10. This change is being implemented by the Centers for Medicare & Medicaid Services (CMS).
National Clinical Modifications of ICD-10 frequently include more detail and a larger number of codes than the International version. The U.S. will have two distinct versions in use:
- ICD-10-CM: ICD-10 Clinical Modifications is used for diagnosis coding to document patient diagnoses in records. The alphanumeric codes are 3 to 7 characters long, and there are approximately 68,000 codes. It will replace Volumes 1 and 2 of ICD-9-CM
- ICD-10-PCS: ICD-10 Procedure Coding System is used for inpatient procedure coding by hospitals and payers. The alphanumeric codes are 7 characters long, and there are more than 72,000 codes. It will replace Volume 3 of ICD-9-CM
- ICD-10 has far more codes than ICD-9 and also codes more specifically. With ICD-10, a user can report a disease and its current manifestation with one code, a feat that isn’t possible under ICD-9
Before the United States transitions to ICD-10, CMS is requiring all users to first adopt EDI Version 5010 by March 31, 2012. This is a new Electronic Data Interchange Standards prepared by HIPAA that will accommodate the increase in size and complexity of codes in ICD-10.
ICD-10 was set to be implemented by all HIPAA-covered entities by October 1, 2013. However, CMS and the U.S. Department of Health and Human Services (HHS) announced mid-February, 2012, that the implementation date will be postponed indefinitely.
How to Prepare for ICD-10 and What to Know About the Transition:
Due to the complexity and specificity of codes in ICD-10, coders and billers should have a strong understanding of anatomy and physiology. Training in ICD-10 should also be undertaken to understand how the new coding system works and to become proficient in it.
While ICD-10-PCS applies only to hospitals and billers, and will not affect coding of physicians in their offices, physicians still should be aware that documentation requirements are different, so inpatient medical record documentation will be affected.
It is anticipated that systems will have access to both ICD-9 and ICD-10 during the transition process, and that mapping between the two sets of codes will be needed to for tracking diseases as well as nationwide studies.
Why the Switch from ICD-9 to ICD-10?
ICD-9 only allows for 10 subcategories in each three-digit category and is organized scientifically. Because of these specifications, there is essentially no more room to expand under ICD-9. New medical discoveries are being made and there are no numbers to assign to them. ICD-10 allows the system to expand and also allows for more specific codes that can include diagnosis and any progression or manifestations due to disease.
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