ICD 10 CM represents the biggest change to the code set used to describe illnesses in individuals and its implementation into US healthcare has been talked about for the past 10 years. As mentioned in a previous post The WHO maintains the ICD coding system and it in fact is in use in 110 other countries around the world. Nations like Australia for example, have been using ICD 10 since 1998. The US is currently using a piece of ICD 10 for is mortality reporting for the CDC but is still using ICD 9 CM for diagnosis coding.
One of the main reasons for the creation of ICD 10 CM is that over the years of ICD’s use there simply isn’t room in the current set of over 13,000 codes to sufficiently report new illness/conditions that are being submitted by various medical societies. Another reason for ICD 10 is that it will allow for greater specificity in describing diseases and illness which in turn will allow for better epidemiology tracking.
Let us look at a couple examples:
ICD 9 CM
Asthma with acute exacerbation is 493.92
ICD 10 CM
mild, intermittent, w/acute exacerbation J45.21
severe, persistent w/acute exacerbation J45.51
The following is the code set for thumb laceration:
ICD 9 CM
Thumb, w/o nail damage, initial encounter 883.0
ICD 10 CM
Laceration w/o FB, right thumb, initial encounter S61.011A
Laceration w/o FB, left thumb, initial encounter S61.012A
One can see in both examples there is now opportunity for greater specificity. The asthma episode can be more clearly defined and the laceration now has a left and right clarification to the location, a degree of specificity not seen in ICD 9 CM. Also the laceration diagnosis went from four digits to seven, with an alpha character. It is changes like these that will require professionals who use these code sets to be retrained.
Organizations like the American Academy of Professional Coders (AAPC), HcPro, OptumCoding, and Supercoder just to name a few offer ICD 10 “boot camps” where individuals can obtain training on how to properly interpret the changes in ICD 10 and be prepared its implementation. These seminars range from $600.00 to $1,000.00 per person; yet another example of industry evolving to meet its changing needs.
Professionals across the industry have anticipated ICD 10 CM with fear and trepidation. CMS has just announced this past week that they will delay the implementation of ICD 10 CM another year. Small practices have expressed difficulty in getting their staff trained and finding software to accommodate the impending changes with ICD 10 CM. This marks the second time that its implementation has been delayed. Providers have been given more time, but will it be enough?