Map ICD-9-CM to ICD-10-CM to ease transition
While there are many steps a practice needs to take to get ready for ICD-10, the ones that most affect providers are documentation improvement and understanding which codes will change for their practice specifically. The best way to prepare for the coding changes is to map ICD-9-CM to ICD-10-CM the most frequently used codes in your practice. Depending on the practice, it could be the top 20 codes or top 100. For many primary-care providers, the number will be more like 20 codes to 50 codes. Mapping these top ICD-9 codes to their ICD-10 equivalents will help providers get a feel for the new codes and prepare to start using them. Providers should not rely entirely on an ICD-9 to ICD-10 crosswalk because some new codes have many very specific options.
With the upcoming switch to ICD-10, major changes are being made. The most important differences between ICD-9-CM and ICD-10-CM to know:
Specific Information:
Similar injuries on opposite limbs having the same code, has been plagued by lack of specifics.This reduces the effectiveness and has caused confusion on many different levels. ICD-10 will offer a greater degree of specific information in areas such as right versus left, initial or subsequent encounter, and other relevant clinical information. The greater degree of specific information is utilized with a number of different methods, many of which are covered below.
Number of Codes:
As part of the effort to provide more information, ICD-10 will have roughly 68,000 available codes in comparison to ICD-9’s 13,000 codes and limited space for additions. Coders will need to understand how to effectively search for codes under the new system, as codes may be somewhat different than before.
Length of Code:
ICD-10 uses codes that are longer (in some cases) than those of ICD-9, following a basic structure.
- Digits 1-3 will now refer to the category
- Digit 1 is always alphabetic
- Digits 2-3 are always numeric
- Digits 4-6 will cover clinical details such as severity, etiology, and anatomic site (among others), and are either alphabetic or numeric
- Digit 7 will serve as an extension when necessary, and will be either alphabetic or numeric
Combination Codes:
The use of combination codes that can be used to classify such things as multiple diagnoses or a diagnosis with a complication is supported by ICD-10. These are expressed as single codes, reducing the number of codes that need to be made while still providing information that is as specific as possible.
Use of Alphabetic Codes:
ICD-9 only permitted numeric codes. In contrast, ICD-10 will make significant use of alphabet codes as part of its work to be more specific. The characters will not be case sensitive, and both alphabetic and numeric codes are intended to retain identical meanings as much as possible throughout code sets and procedure sections.
The additional characters allow for information such as listing the body system, root operation, body part, approach, device, and any necessary qualifier all within one code for a surgical procedure. Use of this may vary somewhat by section.
Relevance to Modern Technology:
With The additional spaces available are partly designed to allow for new technology ICD-10 offers far more integration with modern technology, to be seamlessly integrated into codes, which means fewer concerns about the ability to accurately report information as time goes on.
Other Important Changes to Note in ICD-10-CM:
- Importance of Anatomy : Injuries are grouped by anatomical site rather than by type of injury.
- Incorporation of E and V Codes: The codes corresponding to ICD-9-CM V codes (Factors Influencing Health Status and Contact with Health Services) and E codes (External Causes of Injury and Poisoning) are incorporated into the main classification rather than separated into supplementary classifications as they were in ICD-9-CM.
- New Definitions: New code definitions are provided reflecting modern medical practice .Eg: Definition of acute myocardial infarction is now 4 weeks rather than 8 weeks in some instances.
- Restructuring and Reorganization: Category restructuring and code reorganization have occurred in a number of ICD-10-CM chapters, resulting in the classification of certain diseases and disorders that are different from ICD-9-CM.
- Reclassification: Certain diseases have been reclassified to different chapters or sections in order to reflect current medical knowledge.
In Conclusion: ICD-10 is not a simple update to ICD-9. The structural changes throughout the entire coding system are very significant and there is an increased level of complexity requiring coders to be even more thoroughly trained than before. However, it is possible to prepare for the changes by remembering a few simple guidelines:
- The more familiar with ICD-10, the better.
- The structural changes require a change in the way people think about coding, and understanding it will help to break current coding habits. Medical professionals used to reporting things a certain way so they can be coded may need to change what they say in order to work well with the new system.