The 10th Revision of the International Classification of Diseases (ICD-10) is an international standard for describing medical conditions and procedures. ICD-10-Clinical Modification (CM) will be used by all health care providers to report medical diagnoses, whereas ICD-10-Procedure Coding System (PCS) will be used by hospitals to report inpatient procedures. Physicians, ambulatory surgery centers (ASCs), and hospital outpatient departments—among other providers—will continue to use the American Medical Association’s (AMA) Current Procedural Terminology (CPT) to report outpatient procedures.*
What is the difference between ICD-10-CM and ICD-10-PCS?
In general, ICD-10-CM expands the level of detail and specificity for many medical conditions. The updated classification system uses alphanumeric codes, instead of numeric codes, that are three to seven digits versus three to five digits. The new system also includes combination diagnosis/symptom codes to reduce the number of codes needed to fully describe certain conditions, and allows for the reporting of laterality ( “right” and “left”).
What is the purpose of the transition from ICD-9 to ICD-10?
ICD-10 aims to reflect current advances in medicine and science, allowing for more specificity and a better understanding of complex health situations. ICD-10 uses combination codes, which allow multiple concepts to be combined into one code. While the updated classification system includes several additional codes, many will remain the same, but allow for additional specificity, such as “left” or “right,” “acute” or “chronic,” and more. In addition, the new structure will also allow for further expansion as new medical conditions are discovered and allow comparisons with other countries using the most current ICD revision.
When is the deadline for the ICD-10 transition?
The transition deadline for ICD-10 is October 1, 2015. This is a firm deadline, and no additional delays in implementation are expected. For physician and other outpatient services provided on or after October 1, 2015, health care providers must use ICD-10-CM codes to report diagnoses; inpatient discharges occurring on or after October 1, 2015 will use ICD-10-CM for diagnoses and ICD-10-PCS for inpatient procedures.
What are some tips to help providers prepare for the transition?
- Develop an implementation strategy for your organization. This may include a risk analysis, timeline, checklist, and budget.
- Identify a leader in your organization who can facilitate the implementation process.
- The transition to ICD-10 could create a disruption in cash flow while your practice becomes accustomed to the new system. In preparation for this possible disruption, you might want to consider getting an additional line of credit.
- Participate in ICD-10 training courses if necessary and purchase any needed ICD-10 materials such as the ICD-10 codebook. Refer to the resources question below for information on ICD-10 courses sponsored by the American College of Surgeons (ACS).
- Review your current clinical documentation practices to determine whether they will be sufficient for ICD-10 coding. Work with your case manager and hospital to make sure you are documenting everything correctly in order to best code using ICD-10.
- Reach out to external partners such as your billing service provider, clearinghouse, practice management, electronic health record vendors, hospitals, surgery centers, labs, and others regarding each of their compliance plans for the ICD-10 transition.
- Once all of your systems and external partners are compliant with ICD-10, conduct end-to-end testing prior to October 1, 2015.
What other ICD-10 resources are available?
The ACS will be offering ICD-10 informational courses throughout the year. Additional ICD-10 resources will be posted on the ACS website throughout the year.
The ACS coding hotline can assist with answering ICD-10 coding questions.
The Centers for Medicare and Medicare Services’ (CMS) has official ICD-10 resources and the CMS eHealth University.
Healthcare Information Management Systems Society ICD-10
American Health Information Management Association ICD-10
American Medical Association ICD-10
American Hospital Association Central Office ICD-10
American Academy of Professional Coders’ ICD-10
Online tool for translating ICD-9 codes to ICD-10
*All rights reserved. CPT is a registered trademark of the American Medical Association.