Note: If you are not familiar with ICD-10 basics, please refer to http://www.icd10.net.

On January 16, 2009, the Department of Health and Human Services made the long-awaited published FINAL rule regarding the replacement of the current ICD-9-CM code set with the ICD-10-CM and ICD-10-PCS code sets.  The effective date for implementation has been set as October 1, 2013.

“We are taking a giant step forward toward developing a health care system that focuses on quality and affordability through the implementation of health information technology,” HHS Secretary Mike Leavitt said. “The greatly expanded ICD-10 code sets will enable HHS to fully support quality reporting, pay-for-performance, bio-surveillance, and other critical activities. Conversion to ICD-10 is essential to development of a nationwide electronic health information environment, and the updated X12 transaction standards are a critical step in the implementation of these new codes.”

REPLACEMENT RATIONALE
With the exception of the US and Italy, all other major countries are utilizing ICD-10 and this difference has created problems making national and international comparisons. To further complicate things, the US is using ICD-10 for "cause of death" reporting. Because cause of death and disease classifications are different, it is making statistical analysis and trend comparisons difficult as well.

Besides incompatibility problems, the current system uses antiquated terminology and leaves no room for expansion. By creating a new system, we can address some long-standing issues. For example, cancer registries have been using the oncology section of ICD-10 (ICDO-2) for many years because of ICD-9 limitations.

ICD-10-CM PREPARATION
With implementation in 2 years, now is a good time to start getting familiar with the coding system.  However, please keep in mind that there will be changes before the 2013 deadline is here. InstaCode Institute is preparing ASCII files now and is working with www.FindACode.com to get the new searching available in an easy-to-use online search.

The codes can be searched on www.FindACode.com right now! We have additional tools in the works, but they are not yet all available there. Keep checking backup as they contintue to make changes and enhancements to make your code searching experience a pleasant one. 

Remember, these codes are not valid and should not be used clinically. Updates are expected before ICD-10-CM is implemented. Reports of typographical errors are encouraged along with potential coding problems.

ICD-10-CM HIGHLIGHTS
ICD-10-CM incorporates major improvements in many areas. Codes have been expanded from a maximum of five-digits to a maximum seventh-digit extension resulting in far more codes than in ICD-9-CM. There are also many other changes:

• Added:
  • code extensions for external causes of injury
  • code extensions for injuries
  • laterality
  • trimester information
• Expanded:
  • alcohol and substance abuse
  • injury codes
  • postoperative complications
• Harmonized with other classifications:
  • DSM-IV (mental health disorders)
  • ICDO-2 (cancer registries)
  • Nursing
• Removed relationships with procedures / procedure codes
• Revised diabetes codes to be consistent with American Diabetes Association categories

To help you visualize some of these changes, below are some screen examples comparing a few ICD-9-CM codes to their ICD-10-CM counterpart.

CURRENT CODE SETS
The current code sets adopted by HIPAA are ICD-9-CM, CPT-4, HCPCS, and NDC.

SUMMARY
In summary, this is great news.  Some insurance payers may argue otherwise, but we are far behind the rest of the world and it is time to get into full compliance.  It is possible that there could be further delays, however, in our opinion, it seems very likely that the new codes will be implemented on October 1, 2013.

We also recommend that you take some time to understand how HIPAA rules and regulations apply to you. Follow this link to read more about HIPAA. Article: HIPAA Compliant or Complacent