The International Classification of Diseases, 10th Revision, will go into effect on October 1, 2015. It consists of two parts:
- ICD-10-CM diagnosis coding which is for use in all health care settings.
- ICD-10-PCS inpatient procedure coding which is for use in hospital settings.
ICD-10 will affect diagnosis and inpatient procedure coding for everyone covered by HIPAA, not just those who submit Medicare or Medicaid claims. The change to ICD-10 does not affect CPT Coding for outpatient procedures. CPT Coding will be outlined in a later post.
It is important to understand the major improvements and changes between ICD-9 and ICD-10 diagnosis codes. The changes enhance current medical documentation standards to capture a greater level of detail in patient care.
- The ICD-9 provides no option for laterality; in the ICD-10, Right/Left account for over 40% of codes.
- ICD-9 codes have only 3-5 digits; ICD-10 codes have up to 7 digits.
- ICD-9 has no placeholder characters; ICD-10 allows for “X” placeholders for more specificity.
- ICD-9 contains 14,000 codes; ICD-10 contains 69,000 codes to provide more detail.
- ICD-9 has limited severity parameters; ICD-10 has extensive severity parameters.
- ICD-9 has limited combination codes; ICD-10 has extensive combination codes, to capture complexity.
- ICD-9 has only one type of Excludes Notes; ICD-10 has two types of Excludes Notes.
Other important changes to notes in the ICD-10-CM:
- Injuries are grouped by anatomical site rather than by type of injury.
- The code 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.
- In some cases, new code definitions are provided, which are consistent with modern medical practice.
- Category restructuring and code reorganization within the ICD-10-CM has resulted in certain diseases and disorders being classified differently than in the ICD-9-CM.
- Reclassification of certain diseases reflects current medical knowledge.