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Are you ready for ICD-10 coding?
keywords: ICD-10 codes
Section:  Nursing

 "Electronic claims will need to conform to ICD-10 starting next month, and physicians will need to use ICD-10 diagnostic codes beginning October 2013.”

A current article in Today’s Hospitalist heralds the coming of mandated use of ICD-10 codes. Here is a sampling of excerpts from the article. You can read the whole article at http://todayshospitalist.com/index.php?b=articles_read&cnt=1409

The article is entitled:

It’s the end of the world as we know it  (Published in the December 2011 issue of Today's Hospitalist)by David Frenz, MD, and Sue A. Lewis, RN, CPC, PCS (David Frenz, MD, is a hospitalist for HealthEast Care System in St. Paul, Minn., and is board certified in both family medicine and addiction medicine. He serves as system medical director for addiction medicine and can be reached at dafrenz@healtheast.org. Sue A. Lewis, RN, CPC, PCS, is a compliance consultant with HealthEast Care System.)

 “What's the difference between ICD-9 and ICD-10? Think paper maps vs. GPS.”

“A little history
The ICD was first issued in 1893 as the "International List of Causes of Death." The document, which focused mainly on mortality, was updated roughly every 10 years beginning in 1900.”

“Various countries, including the U.S., introduced parallel classification systems of injuries and nonfatal illnesses. The morbidity and mortality rubrics were merged into one "Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death," published in 1949.”

“Subsequent revisions occurred in the 1950s, 1960s and 1970s. The ninth iteration, known as ICD-9, should start to ring a few bells. Think numbers—lots of numbers—and your friendly neighborhood coder.”

“A tenth revision, ICD-10, entered general use in 1994, but the U.S. has been very slow on the uptake. So slow, in fact, that ICD-11 has already appeared in draft form before ICD-10 has been implemented here, an embarrassing 20-year lag. But the clock is ticking: Electronic claims will need to conform to ICD-10 starting next month, and physicians will need to use ICD-10 diagnostic codes beginning October 2013.”

“Numbers and letters
As you all know, ICD-9 is organized into 19 chapters, many of them dealing with diseases of a specific organ. ICD-9 offers some 14,000 codes to choose from.”

“ICD-10 retains a similar organization. But the number of diagnostic codes balloons to 68,000. (Plus, there are an additional 87,000 procedure codes, an astonishing increase from the mere 4,000 in ICD-9.)
What's the difference between the two systems? Think paper maps vs. GPS. In both ICD-9 and ICD-10, each code starts with a three-character category. ….In the former,(ICD-9) the first character can be either a number or letter; in the latter,(ICD-10)the first character is always a letter. Remaining characters further qualify the diagnosis with respect to etiology, location and severity. ICD-9 codes have up to five characters in total, while ICD-10s can tack on another two.”

“The changes are so far-reaching that the World Health Organization (WHO), in addressing frequently asked questions about ICD-10, states simply: "It is not possible to convert ICD-9 data sets into ICD-10 data sets or vice versa."
“What details count in ICD-10?The ICD-10 revIsIon includes four times as many codes as the version that physicians are now using. That means that codes are about to become much more specific.”


I went to the World Health Organization website to see what is in store for diabetes… If you  would like to see for yourself, go to http://apps.who.int/classifications/icd10/browse/2010/en#/IV 
Chapter IV: Endocrine, nutritional and metabolic diseases(E00-E90) and Diabetes Mellitus (E10-E14)

Re: Are you ready for ICD-10 coding?

I don't know much about it.  I know that we will have MANY more codes than we currently have.  

I have heard that Medicare will not be ready but that it will happen nonetheless.  And that I should get an update from my EMR vendor very soon with the new code set implemented.  

What I find interesting is that I haven't heard anyone at work talking about it.  We have recieved nothing from our EMR team warning us of a change coming up or anything like that.  I think that is what is scarier than the change itself to me.  

I know we will have many more codes.  I heard there is a code in ICD 10 for "sucked into a jet engine".  

I assume the update is because we are all using EMRs now and everything must have a code in order to be billed and tracked.  Wow.  I wonder how they came up with all those codes.  I bet there will still be some they didn't think of.