ICD-10-CM - 2007 Update
by Wyn Staheli
Note: If you are not familiar with ICD-10 basics, please refer to http://www.icd10.net.
Senate bill S. 628, the "Critical Access to Health Information Technology Act of 2007" (introduced by Senator Norm Coleman of MN) has been introduced. Part of the wording of this bill requires replacing ICD-9-CM with ICD-10-CM by October 1, 2011. This is not the first time congressional leaders have tried to help start jump start this stalled implementation. As of 2/15/2007, it was referred to the Senate committee on Health, Education, Labor and Pensions. Hopefully this time, it will pass. We recommend contacting your senator to let them know of your support for this bill.
Another recent development is the July 2007 release of the updated ICD-10-CM code set. It is most likely that there will continue to be updates to this set as groups and individuals evaluate the data.
In June 2007, a letter was written to Michael Leavitt, the Secretary of the Department of Health and Human Services by several organizations. They urged him to adopt and implement ICD-10-CM and ICD-10-PCS by October 1, 2011. These organizations were: Advanced Medical Technology Association (AdvaMed), American Health Information Management Association (AHIMA), American Hospital Association (AHA), American Medical Informatics Association (AMIA), Federation of American Hospitals (FAH), Medical Device Manufacturers Association (MDMA), Premier, and Siemens
Previously, in May of 2002, the National Subcommittee on Standards and Security held hearings on HIPAA Code Set Issues. This committee reports to the Department of Health and Human Services (HHS) on national health information policy. Many of the key players in the coding arena were present to discuss the possible replacement of current HIPAA coding sets, including ICD-9-CM with ICD-10-CM.
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
During the hearings, the ICD-10-CM pre-release draft was given out. In the words of one committee member, they are calling this a "near final draft." The purpose of this pre-release is to have people familiarize themselves with the new format and make sure that any final problems are worked out before the final release. It was emphasized that these codes are not valid and should not be used clinically. Updates are expected before ICD-10-CM is implemented. However, no comments are being accepted on the content at this time. 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
Last year, we stated that the code sets adopted by HIPAA were ICD-9-CM, CPT-4, HCPCS, NDC and the Code on Dental Procedures and Nomenclature. There is one change to be noted. On May 31, 2002, in response to public comment, the HHS proposed to repeal the adoption of National Drug Codes as the standard medical data code set for reporting drugs and biologics for everyone except retail pharmacies. At this time, we have not yet seen the final rule.
SUMMARY
In summary, major changes are coming, but without a final notice, it is unclear exactly when these changes will take place. Even during the hearings, people had differing opinions on when implementation should occur. With the required HIPAA two-year implementation window, there is no cause for immediate concern. In the meantime, use the current code sets.
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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