The Coming of the ICD-10

October 1st, 2014 is the current date declared by the Department of Health and Human Services when coding based on the ICD-10, shorthand for the International Classification of Diseases Tenth Revision, will go into effect, replacing its outdated predecessor by over 30 years, the ICD-9. This former’s 17,000 codes will now be expanded into the 155,000-plus codes contained within the ICD-10. All healthcare organizations covered by the Health Insurance Portability and Accountability Act (HIPPA) must transition to billing according to the ICD-10 before this date, and those who are not covered by this will still need to convert or face the prospect of becoming obsolete. So the question is, are you ready?

As a general rule, most coding professionals advise training for the the ICD-10 to begin by April 1st, six months before the conversion. This should give the health care industry plenty of time to prepare for the new changes, and as a medical billing and coding professional you should be particularly adept at coding so the transition will not be rocket science. However in case you were thinking about getting used to the new coding system ahead of time, the Centers for Medicare and Medicaid Services (CMS) will not be able to process any submissions in the ICD-10 format until October 1st, 2014.

So What Is Different?

Generally, the ICD-9 and ICD-10 share a similar format, and the ICD-10 CM (Clinical Modification) has a tabular list and an alphabetical index just like the ICD-9 CM. Punctuation, abbreviations, notes and symbols all have the same meaning too. As suggested by the addition of more than 67,000 more codes, one of the key differences between these versions is that the ICD-10’s coding provides for a much greater depth of detail and specificity.

Some other differences in the ICD-10 CM include an Index to External Causes of Morbidity, separate chapters devoted to “V” and “E” codes, and several of the previous chapters as seen in the ICD-9 CM have had their codes restructured and their categories reorganized. Coding lengths for the ICD-10 CM have also been increased, and can now include three to seven alpha-numeric characters. Starting October 1st, medical billing and coding professionals will also need to designate which side of the body has been afflicted. For example, instead of coding for a snake bite on the foot, it will be necessary to use the correct code for a snake bite and the corresponding left, right, or both feet where it occurred.

It is also important to realize that the ICD-10 will not replace Current Procedural Terminology (CPT) coding or Healthcare Common Procedure Coding System (HCPCS) codes.

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Tips for Preparation

The federal Centers for Medicare and Medicaid Services has plenty of educational resources and tips about transitioning to the ICD-10, including code tables, indexes, and tabular descriptions. As a medical billing and coding professional, it will be very helpful to review the sections which you deal with on a day-to-day basis.

Another thing to consider is whether or not your employer or contractor is ready for the transition. The American Medical Association has gone so far as to recommend physicians establish a line of credit to mitigate any income disruptions. If it seems that initial disruptions may disrupt your paycheck, you should consider approaching those you work with to ensure they are prepared for some initial bumps in the road.

If you use any medical billing and coding computer software you will also need to make sure this is up-to-date.

Giving yourself plenty of time to become familiarized with the ICD-10 will ensure you make a smooth transition. Remember, this is not the tenth edition, it is the tenth revision– meaning that despite some numbers that might sound overwhelming, the ICD-10 is simply a more modern, logical, and orderly way to organize classifications.