Preparing for ICD-10-CM forPathology Practices

Presented by Cindy Hegner, CCS

CUG 2011

What We Will Cover

• When will we start using ICD-10• Who needs to be familiar with ICD-10• Staff Education Costs• Comparing ICD-9 with ICD-10• New features of ICD-10• A brief summary of the Chapters of ICD-10• Recommended web sites and reference books

THE BIG QUESTION

Will the Effective Date of ICD -10-CM be extended?Answer: No.

At the ICD-10 Summit in Washington DC on April 12, 2011, Karen Trudel, the acting director of CMS’s Office of E-Health Standards and Services stated:

“THE DEADLINES ARE NOT CHANGING”

Who Needs to be Familiar with ICD-10-CM

• Senior Management• Clinicians• IT Personnel• Data Security Personnel• Billing Personnel• Coding Personnel• Accounting Personnel

Staff Education Costs1. Will you outsource the education or conduct it

internally? If you have a coding expert on staff consider the time it

would take for him/her to train your staff2. What are the costs and benefits of these two

options?3. When will the education need to be done?

It is recommended to start the training your personnel six months prior to October 2013.

If you start too early, your staff will forget what they learned before having to apply their ICD-10 coding knowledge.

4. Who will need what level of education?

Staff Education Costs

5. What options are available for education? Web based training Face to face workshops Books Audio seminars

6. How will the workload be managed while staff are receiving education?

Comparing ICD-9-CM to ICD-10-CM

ICD-9-CM• Approximately 13,000 codes• Consists of three to five

characters.• First digit is numeric or Alpha

(E or V)• Second, third, fourth and fifth

digits are numeric.• Always at least three digits• Decimal placed after the first

three characters

ICD-10-CM• More than 68,000 codes• Consists of three to seven

characters• First digit is alpha• All letters used except for U• Second and third digits are

numeric• Fourth, fifth, sixth and seventh

digits can be alpha or numeric• Decimal placed after the first

three characters

Code Structure of ICD-10-CM versus ICD-9-CM

ICD-9-CM Code Format

X X X . X X category etiology

anatomic site, manifestation

ICD-10-CM

X X X . X X X X category etiology, extension

anatomic site manifestation

New Features Found in ICD-10-CM

1. Laterality (left, right, bilateral)2. Combination codes for certain conditions and

common associated symptoms and manifestations

3. Combination codes for poisonings and their associated external cause

4. Obstetric codes identify trimester instead of episode of care

New Features Found in ICD-10-CM

5. Character “x” is used as a 5th character placeholder in certain 6 character codes to allow for future expansion and to fill in other empty characters when a code that is less than 6 characters in length requires a 7th character, (example T15.02xD)

6. A number of codes have been significantly expanded (injuries, diabetes, substance abuse and postoperative complications)

7. Injuries are grouped by anatomical site rather than by type of injury

New Features Found in ICD-10-CM

7. Certain diseases have been reclassified to different chapters or sections in order to reflect current medical knowledge

8. New code definitions (e.g., definition of acute myocardial infraction is now 4 weeks rather than 8 weeks)

9. V codes and E codes are incorporated into the main classification rather than separated into supplementary classifications as they were in ICD-9-CM

Chapters in ICD-10-CM1. Infections and Parasitic Diseases (A00-B99)2. Neoplasms (C00-D49)3. Diseases of the Blood and Blood Forming Organs and

Certain Disorders Involving the Immune Mechanism (D50-D89)

4. Endocrine, Nutritional and Metabolic Diseases (F01-F99)

5. Mental and Behavioral Disorders (F01-F99)6. Diseases of the Nervous Systems (G00-G99)7. Diseases of the Eye and Adnexa (H00-H598. Diseases of the Ear and Mastoid Process (H60-H95)

Chapters in ICD-10-CM9. Diseases of the Circulatory System (I00-I99)10. Diseases of the Respiratory System (J00-J99)11. Diseases of the Digestive System (K00-K94)12. Diseases of the Skin and Subcutaneous Tissue (L00-

L99)13. Diseases of the Musculoskeletal and Connective

Tissue (M00-M99)14. Diseases of the Genitourinary System (N00-N99)15. Pregnancy, Childbirth and the Puerperium (O00-O9A)16. Certain Conditions Originating in the Perinatal Period

(P00-P96

Chapters in ICD-10-CM17. Congenital Malformations, Deformations and

Chromosomal Abnormalities (Q00-Q99)18. Symptoms, Signs and Abnormal Clinical and

Laboratory Findings, Not Elsewhere Classified (R00-R99)

19. Injury, Poisoning and Certain other Consequences of External Causes (S00-T88)

20. External Causes of Morbidity (V00-Y98) Classification of environmental events and circumstances as the case of injury and other adverse effects

21. Factors Influencing Health Status and Contact with Health Services (Z00-Z99)

Recommended Web Sites

• ICD-TEN e-newsletterhttp://www.ahima.org/images/newsletters/icdTen/subscribe.html

• AHIMA ICD-10http://www.ahima.org/icd10/default.aspx

Quick Reference Informationhttp://www.cms.gov/ICD10/Downloads/ICD-10QuickRefer.pdf

CMS Provider Resourceshttp://cms.gov/ICD10/05a_ProviderResources.asp#TopOfPage

ICD-10 Data.com is free access to ICD-10 medical codes http://www.icd10data.com

Recommended Books

• ICD-10-CM and ICD-10-PCS Preview from AHIMA• Detailed Instruction for Appropriate ICD-10-CM

Coding from Ingenix• 2011 Advanced Anatomy and Physiology for ICD-10-

CM/PCS from Contexmedia

QUESTIONS?????????