Understanding ICD 10 for Medical Practice Offices

I will gather as many useful information and website free resources for us to learn more and be awesome for ICD 10! Remember, we have now a final date of October 1, 2015.

What is ICD 10?

ICD 10 was developed by the World Health Organization (WHO). It is the 10th Revision of the International Classification of Diseases. Many countries
are already been using the ICD-10.

In the United States, we have the ICD-10-CM for diagnosis coding and will be used in all physicians and health care settings for reporting medical
conditions, reason for the encounters, data collection, for payment and reimbursement and all other pertinent purposes.

Number of Characters: 3-7 Alphanumeric Characters

First Digit is an alpha character (a-z)
Second Digit is a numeric character (0-9)
Third to Seventh Digit is either alpha or numeric character

ICD-10-CM has approximately 68,000 codes while the current ICD-9 has 13,000 codes approximately.

So what are ICD 10 Codes? ICD-10-CM

Here’s a Figure for the Mapping and how we can easily understand ICD 10 Coding:


icd 10 and understanding mapping

ICD 10 Photo Source: jamia.oxfordjournals.org


ICD 10 are very specific codes (so you will be able to code based on its highest specificity)
ICD 10 will allow you to accurately code based on:

Comorbidities (eg.if there are two or more coexisting conditions in addition to an initial diagnosis)
Signs and symptoms
Etiology (eg. underlying conditions)
Abdormal Findings
Social status and circumstances
Detailed anatomical site
Functional impairment
USe of Biological and Chemical Agents
Phases and different stages
Specific with joint involvement
Different involvement of the Lymph Nodes
Lateralization (right and/or left)
Related to Implants and Surgical Procedures
External Causes of injury

I can only see advantages on ICD 10 (seriously!)
*** If you have a more specific code by description including its lateralization, this may help avoid cross-referencing with other codes;
*** And I think with the implementation of ICD 10 CM, tedious claims appeals (due to so many additional information required to establish medical necessity by the insurance payors) can be avoided

*** By submitting the most specific diagnosis codes, this can also help maximize reimbursement
*** Accurate coding with the highest specificity can also lead to a better, secured and good quality patient care
*** The data collection and with specific, accurate coding, research and development in medicine and emerging technologies may improve significantly.
*** It can avoid healthcare fraud and abuse

My thought of having so many codes?! — it doesn’t mean it would be tougher to find a code, trust me — this will be easier for us to find the most
accurate and specific code! Why? – because these codes are presented in its highest and accurate, very specific codes!

What is ICD 10 PCS? (Procedure Coding System)

The ICD 10 PCS will be used as a procedural codes for inpatient and
hospitals settings.

Number of Characters: 7 Alphanumeric characters

ICD 10 PCS has approximately 87,000 codes while the current ICD-9 has
3,000 codes approximately.

-> Used for procedural coding in an inpatient hospital setting
-> Developed by CMS

Important to know!
Physician offices and Ambulatory Services will continue using the CPT Codes and HCPCS Codes.

I put together many website links (from your payors and other HIM and Coding Organizations) that offers free information and education on ICD-10-CM and ICD 10 PCS. Please click here.

No questions found.

Author: Pinky Maniri

Ms. Pinky, as she is fondly called - is a Reputable Professional Consultant and Expert in Practice Administration, Medical Billing, Coding, Health Information Technology, Insurance Credentialing and Compliance for Physician Offices. Well-educated with a Degree in Computer Systems Engineering and a background in Clinical Nursing and Small Business Management. Her professional mission is to make sure her clients/physicians maximize reimbursement while they remain compliant with the current rules, changes, guidelines and policies. Read More About Ms. Pinky here and See what Other's say about her Expertise Testimonials

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