What are ICD 10 Codes?
ICD-9 codes are nearly 30 years old and cannot be expanded any further diagnosis. Many of its diagnosis categories are full. ICD 9 codes are 3 to 5 characters. The first can be numeric or alpha, the 2nd through 5th are numeric with a decimal after the third character.
ICD 10 codes are 3 to 7 characters, the first one is alphabetic, 2nd through 7th are either alphabetic or numeric, with a decimal after 3 characters. These codes are arranged in chapters and sub-chapters with diseases grouped by letter. ICD 10 allows increased detail and the flexibility for emerging diagnosis. It is robust and has a logical structure with clear consistent definitions. It allows over 155,000 diagnosis codes compared to a maximum of 17,000 ICD 9 codes.
The greater number of codes in the ICD 10 will make it easier to find the right diagnosis code. ICD 10 has an improved structure and specificity; it should be easier to use than ICD 9. Most practices use a relatively small number of codes related to the type of specialty.
Part of HIPAA
HIPAA legislation included the requirement for use of ICD 10 with a compliance date of October 1, 2013 for implementation. The government agency requiring implementation is the Department of Health and Human Services (HHS). HHS has no plans to delay implementing.
Related to the switch to ICD 10 is the transition to the version 5010 standard for electronic transactions effective January 1, 2012. The 5010 changes are necessary to accommodate ICD 10 codes and NPI.
ICD-9 will no longer be maintained after implementation of ICD 10. ICD 10 is currently in use by other countries and is updated annually just like ICD 9.
Concerns
The issues that concern most providers and billing services are the potential economic impact. Will practice management systems be able to accommodate the greater number of diagnosis codes (up to 155,000) for ICD 10? Software applications from the front end physicians office to the clearinghouse to the payer will have to be able to accommodated ICD 10.
Will payers that don’t yet use ICD 10 codes map everything back to ICD 9 for processing?
Another complication is that some ICD 10 codes are unique to the encounter. So the initial patient visit may use one ICD 10 code while subsequent visits will require another.
Estimates for healthcare providers, coders, and billers to become proficient with ICD 10 is 6 months.
