ICD-10: The New Standard in Coding

CMS Proposes Adopting ICD-10 Codes as Standard

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) and the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) have been proposed to be concurrently adopted as the standard code sets for coding diagnoses and inpatient hospital procedures, respectively. According to the Proposed rules, facilities would need to migrate to the ICD-10 code set by October 1, 2011. Until this time, the current ICD-9 code set will continue to be accepted.

For years we've been hearing about how we need to move from the current ICD-9 code set to the ICD-10 code set. Why? Well, the functionality of ICD-9 codes has been exhausted and the code set can no longer add classification specificity, newly identified disease entities, and other advances that the ICD-10 codes would address. Basically, we've completely run out of ICD-9 codes to use.

The ICD-10 code set would impact official coding guidelines for coding diseases, injuries, impairments, other health problems and their manifestations, and causes of injury, disease, impairment, or other health problems. HIPAA covered entities would be required to use the ICD-10-CM codes when diagnoses and hospital inpatient procedures need to be coded in HIPAA transactions. ICD-10-PCS codes would not be used in outpatient transactions, because the codes are limited to inpatient procedures. An ICD-10-CM/PCS committee would also be established to coordinate and consider the usage of new codes and revisions to existing codes. Any impact on prospective payment systems currently using ICD-9-CM codes would be addressed by proposed regulations within those systems.

The current ICD-9 code set includes 17,000 codes; whereas the ICD-10 code system will include 155,000 codes. If you're like me, when you hear that number you begin to feel it may be time to explore a new career. But seriously, the new ICD-10 is meant to make our lives easier in the future. According to CMS, it will provide the opportunity to report greater specificity for procedures and services also will significantly improve tracking outcomes data for new technologies and treatment.

To get started, your facility should become familiar with the new code system so that you have a better understanding of the education you and your colleagues will need to implement these changes. Once you get a good handle on the code set, you should consider focusing on implementing a crosswalk from the ICD-9 code set to the ICD-10 code sets. Likely, many vendors will have a crosswalk for sale that will make your life easier in the transition period. Lastly, your facility will need to figure out how your billing and payment and clinical systems will be impacted by the code change.

  Proposed rule, 73 FR 49795, Aug. 22, 2008; Proposed rule, 73 FR 49741, Aug. 22, 2008. These Proposed rules can be viewed on the CCH Internet Research Network at ¶220,697 and ¶220,676, respectively.