Other articles in Summer 2007
Coding Corner: The Future of Coding - ICD-10-CM and ICD-10-PCS
The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) and The International Classification of Diseases, Tenth Revision, Procedure Classification System(ICD-10-PCS).
Currently 138 countries have implemented ICD-10-CM for mortality reporting and 99 countries have implemented it for morbidity reporting, with the United States still using the ICD-9-CM system it is difficult to compare our health data with international data. Although, the United States implementation of either one of these systems has not been announced, draft legislation contains a provision to implement ICD-10. Implementation will be based on the process for adoption of standards under the Health Insurance Portability and Accountability Act (HIPAA). There will be a two-year implementation window once the final notice to implement has been published in the Federal Register.
<p.If passed, HR 4157, The Health Information Technology Promotion Act, would require the Secretary to implement ICD-10-CM and ICD-10-PCS on October, 1, 2009.
- Improvements to the quality of care and patient safety.
- Fewer rejected or questionable reimbursement claims.
- Improved information for disease management.
- More accurate reimbursement rates for emerging technologies.
- Better understanding of the value of new procedures.
Major changes in the ICD-10-CM include:
- 21 chapters (ICD-9 has 17).
- The E-codes and the V-codes are incorporated within the new system rather than the current supplementary classifications.
- Identification of trimesters to obstetrical codes.
- Expanded diabetes, injury, alcohol/substance abuse, and postoperative complications.
- Ability to report laterality (to specify whether a medical condition occurred on the right or left side).
- Standard definitions for “excludes” notes.
- Combination diagnosis/symptoms codes.
- Identification of initial encounter, subsequent encounter, and sequelae of injuries.
- Expanded external causes of injuries.
- Improved clinical detail.
- Addition of a sixth character.
- Addition of a seventh character extension in some chapters. (ICD-9, max 5).
The ICD-10-CM is published by the World Health Organization (WHO) you may find the guidelines for the use of this classification in the Official Coding and Reporting Guidelines of ICD-10-CM (www.cdc.gov/nchs/icd9.htm).
Major changes in the ICD-10-PCS include:
- 15 sections in the ICD-10-PCS with almost eighty eight thousand codes compared to the maximum of ten thousand codes of our present system.
- Consists of alphanumeric codes rather than all numeric codes. The current system contains a maximum of four numbers with a decimal point, the new system has a maximum of seven characters with no decimal point.
- The includes and excludes notes are not included in the new system.
- All codes have a unique definition
- Ability to aggregate codes across all essential components of a procedure.
- Extensive flexibility.
- New procedures and technologies are easily incorporated.
- Code expansions do not disrupt systematic structure.
- Limited use of NOS and NEC categories.
- Terminology is precisely defined and used consistently across all codes.
- No diagnostic information is included in the code.
- Increases accuracy and efficiency by being able to recognize and report the procedures performed.
For detailed information on the development of ICD-10-PCS visit the CMS Web site: www.cms.hhs.gov.
As our world grows smaller the need for accurate health data will benefit us all.