ICD-10 Basics: What is ICD-10?

Summary

ICD-10, the International Classification of Diseases 10th edition, replaces the outdated ICD-9 to address new medical discoveries and provide more detailed diagnostic and procedure codes. The system is split into ICD-10-CM for diagnostics and ICD-10-PCS for inpatient procedures. ICD-10 includes 69,000 alphanumeric codes, a significant jump from ICD-9's 14,000. This change improves claims accuracy and data standardization but will require a better understanding of anatomy. Mandated by HIPAA, the transition is costly and time-consuming, but necessary for the evolving medical field.

Takeaways

• 📘 ICD-10 stands for International Classification of Diseases, 10th edition, and it’s an updated version of ICD-9.
• 🧑‍⚕️ ICD-10 is divided into two systems: ICD-10-CM for diagnostic coding used by healthcare providers, and ICD-10-PCS for inpatient procedure reporting used by hospitals.
• 🕰️ ICD-9 is over 40 years old and has run out of room for new codes, which is why ICD-10 is necessary.
• 🌍 The US is one of the last countries to adopt ICD-10, while other countries have already moved on.
• 🔢 ICD-9 codes are numeric and mostly five digits, while ICD-10 codes are alphanumeric and can range from 3 to 7 digits.
• 📊 ICD-9 has 14,000 codes, whereas ICD-10 has 69,000 codes, providing more detail for medical diagnoses.
• 🧠 ICD-10 requires more knowledge of anatomy since the codes are organized by organs and structures.
• 💡 The additional detail in ICD-10 helps standardize data for analysis and streamlines claim submission processes.
• 💸 Transitioning to ICD-10 could be costly for practices, with estimates of thousands of dollars for implementation.
• ⚖️ HIPAA requires the transition to ICD-10, and failing to properly code could negatively impact revenue and cash flow.

Q & A

What does ICD-10 stand for?

ICD-10 stands for International Classification of Diseases, 10th edition.

How does ICD-10 differ from ICD-9?

ICD-10 is the updated version of ICD-9, offering more codes (69,000 vs. 14,000), alphanumeric coding, and the ability to include greater detail, such as laterality and anatomical specificity. ICD-9 is also over 40 years old and has run out of room for new codes.

What are the two systems in ICD-10?

ICD-10 is split into two systems: ICD-10-CM (Clinical Modification) for diagnostic coding used by healthcare providers, and ICD-10-PCS (Procedure Coding System) for inpatient procedure reporting, used by hospitals.

Why was it necessary to move from ICD-9 to ICD-10?

The move to ICD-10 was necessary because ICD-9 is over 40 years old and lacks sufficient codes for new medical discoveries and diseases. ICD-10 offers more detailed codes and the ability to keep up with changes in medicine.

How many codes does ICD-10 have compared to ICD-9?

ICD-10 has 69,000 codes compared to ICD-9's 14,000 codes.

How are ICD-10 codes structured differently from ICD-9 codes?

ICD-10 codes are alphanumeric and can have 3 to 7 digits, while ICD-9 codes are mostly numeric with a few E and V codes and are limited to 5 digits.

Will learning ICD-10 be difficult due to the increase in codes?

Although ICD-10 has more codes, much of the increase is related to laterality and anatomical details. However, coders will need to learn more about anatomy to use the ICD-10 system.

How does ICD-10 improve the healthcare coding process?

ICD-10 offers more detailed codes that help standardize data for analysis, streamline claim submission, and make it easier for payers to understand and process claims.

What law mandates the transition to ICD-10?

The transition to ICD-10 is mandated by HIPAA (Health Insurance Portability and Accountability Act).

What are some challenges practices might face when implementing ICD-10?

The transition to ICD-10 could be costly, with the AMA estimating thousands of dollars in implementation costs. Practices may face issues with coding and documenting properly, which can lead to cash flow problems and increased time spent on correcting and resubmitting claims.