The ICD-9 (International Classification of Diseases (ICD)) codes that are used to report medical diagnoses and inpatient procedures will be replaced by the ICD-10 code sets in October of 2014 (This is not to be confused with the 2013 CPT codes. The CPT codes for 2014 will remain relatively unchanged from the previous year).
ICD-10-CM/PCS (International Classification of Diseases, 10th Edition, Clinical Modification /Procedure Coding System) consist of two distinct parts:
- ICD-10-CM for diagnosis codes
- ICD-10-PCS for inpatient procedure codes
Diagnosis Codes will be Longer and Possibly Harder to Remember
The ICD-10-CM will be for use in all US Health Care Settings. Diagnosis codes under the new CM will use 3 to 7 digits (instead of 3 to 5, but fear not! The format of the code sets will be very similar to ICD-9).
The ICD-10-PCS is for use in U.S. inpatient hospital settings only. ICD-10 PCS uses 7 digits (but with letters AND digits) instead of the 3 or 4 numeric digits used under ICD-9-CM. Coding under the new ICD-10-PCS will be much more specific and different from the previous version of ICD-9-CM.
Why is this Happening?
For starters, the ICD-9 is outdated and has not been updated in 30 years. Being so old, much of the ICD-9 is outdated and is not consistent with current medical practices. The ICD-10 will allow doctors and medical professionals to have more data about the medical conditions of patients (since the structure of ICD-9 limited the number of new codes that can be created).
Who will the ICD-10 Codes Affect?
If you are a medical professional, you will be affected. The ICD-10 will affect all diagnosis and inpatient procedure coding for all those under the Health Insurance Portability Accountability Act (HIPAA) (not just medicaid and medicare). Healthcare providers, payers, billers, clearinghouses, billing software, hospitals, etc, will all be affected…
Steps You Need To Take
Develop a strategy to deal with the changes. You may need to create time to send your medical professionals to conferences and workshops to learn more. Alternately, if you have a billing service, just check with them to make sure they are current and have the bandwidth to update to the new changes.