Why the Change to ICD-10? What does it mean to Providers?

Are you Ready?

ICD-10 codes came from the National Center for Health Statistics (NCHS). They serve to:

• Describe the patient's current health status 
• Explain why medical services were performed 
• Provide data for public health and disease surveillance efforts 
• Use same codes as global mortality. 

The periodic revisions of ICD-9-CM mirror changes in the medical and health care field. The U.S. has been using ICD-9-CM since 1979, and it is not sufficiently robust to serve the health care needs of the future. The content is no longer clinically accurate and has limited data about patients’ medical conditions and hospital inpatient procedures, the number of available codes is limited, and the coding structure is too restrictive.

The U.S. cannot directly compare morbidity diagnosis data to state and national mortality data, because mortality data have already transitioned to ICD-10 code sets and internationally, most developed countries transitioned to ICD-10 code sets decades ago. The value of ICD-10 makes it clear that the main purpose of using ICD codes is not for billing.

Biggest Challenge for Providers

For physicians, the biggest challenge in the change to ICD-10 is the need for high quality documentation that includes more detail for diagnoses than was previously required.

ICD-10 is comprised on seven alpha-numeric codes. Some codes map directly to ICD-9 codes; many map to many different codes. ICD-10 uses combined codes for conditions and their associated symptoms. Two of the main differences from ICD-9 codes are Laterality and Expanded classifications. Laterality is the specific code for left or right ear, arm or other body part. Expanded classifications record status of disease and associate it with related combinations of disease characteristics.

Adjectives bring greater specificity to the ICD-10 code. Examples of adjectives include: acute or subacute; chronic, intermittant, mild, moderate, severe; primary vs secondary; major. The new coding also includes laterality and 

Meaningful Use Experts ICD-10 Conversion Package

Meaningful Use Experts offers an ICD-10 Conversion Project Management package. Includes:

An ICD-10 Comparison Utility for all clients to easily upload and generate test 837 claim files and analyze 835 remittance data in an effort to:

• Create a valid 837 EDI file to send to Clearinghouse or Payer for testing purposes to prepare for coding and reimbursement change.
• Help providers better understand which codes are being utilized more frequently than others and improve efficiency. 
• Allow coders to drill down further with ICD codes to assist with better reporting

An ICD-10 Conversion Package that helps providers with the workflow changes and training required to transition to ICD-10.

Begin now, to make sure that your EHR and staff are ready for October 1st, 2014 when all billable claims must be submitted in ICD-10-CM to be reimbursed. Please call (800) 409-0096 to arrange for a free ICD-10 assessment now.

Provider Education

Doctors can go to the 4Med Online Education courses  on this site to sign-up for an online course on ICD-10.