Diving into ICD-10? Things You Must Know!

It’s been more than a few weeks since the implementation of ICD-10 across the country.  ICD-10 was endorsed by the World Health Assembly in 1990; WHO member states started using it as of 1994.  The United States too made the first draft of ICD-10 available in 1995.  Fast forward to 2015, two decades later, and we still lament the lack of time in preparing for ICD-10.  Although, we cannot really judge the depth of the waters till we actually dive in; let’s see what we discovered when we actually dove into ICD-10.

Let’s first look at the positive changes with ICD-10 implementation

  • ICD-10 provides combined codes for particular conditions, typical associated symptoms and disease manifestations.
  • Injuries can now be coded anatomically rather than by injury type.
  • The number of diseases is now re-classified into different sections, enabling better coding specification.
  • Unlike ICD-9, ICD-10 has ‘Causes of Injury’/‘Poisoning’ as Primary Classifications and not as Supplementary Classifications.
  • Contradictory to the ICD-9 alphanumeric codes with 5 digits, ICD-10 codes have 7 digits, which begin with any letter except ‘U’ followed by a numeric digit and any combination (except ‘U’) – depending on the code for the following 5 digits.

There are a number of other additional features to ICD-10 but let’s look at the other side of the coin.

Throwing caution to the wind? You might want to reconsider

  • With fairly limited codes in ICD-9, the general practice for coders was to use the same codes for two different diagnoses. With ICD-10 however, providing a more detailed version of codes, coders are facing a hard time finding appropriate codes for every minute detail.
  • ICD-10 has a wide range of codes for possible inconsistencies. Ignoring the inconsistencies may result into a reduced reimbursement or total denial from the payer.
  • Frequent codes can cause a problem if one is in a habit of using a certain code regularly. For example, earlier stomach pain could possibly be defined in one code. Today, there are more codes that could be applied to the same diagnosis.  This will hamper the accuracy of existing codes and cause miscoding – coders need to stay on their toes regarding this.
  • An interesting study conducted in 2013 on certified ICD-10 coders by the Healthcare Information and Management Systems Society (HIMSS) and the Workgroup for Electronic Data Interchange (WEDI) brought to light that coders often mix-up between the number 0 (Zero) and the alphabet ‘O’. Not only that, goof-ups were also seen in the number 1 (One) and letter ‘I’.

Training one’s internal team to manage coding does have its benefits.  However, it is vital to get external help in ironing out the kinks.  For assistance with ICD-10 Codes, e-mail us or call (800) 898 0709.


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