ICD-10-CM - 2008 Update
by Wyn Staheli
Note: If you are not familiar with ICD-10 basics, please refer to http://www.icd10.net.
September 18, 2008, the Department of Health and Human Services made the long-awaited announcement of a proposed regulation that would replace the current ICD-9-CM code set with the ICD-10-CM and ICD-10-PCS code sets.
“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 PRE-RELEASE
In July of 2007, an updated ICD-10-CM release was made available for the purpose of having people familiarize themselves with the new format and make sure that any final problems are worked out before the final release. 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.
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. It is the first step in getting a final adoption by October 1, 2011. There is still time for comments and it is possible that there could be further delays, however, in our opinion, it seems very likely that the new codes will be implemented in 2011.
Please keep in mind that there is still plenty of time and there is no official rule yet so there is no cause for immediate concern. Keep using the current code sets until you have been informed otherwise.
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
For any questions please contact
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