ICD-10 and beyond

Reflect on your journey to ICD-10 and use this information for the future.

With ICD-10 diagnosis and procedure codes, chiropractic offices are required to make the switch with all services billed for patients covered by the Health Insurance Portability Accountability Act (HIPPA) billed under the new codes on October 1.

Getting your practice ready for these changes was important not only for ICD-10, but also for future versions of the International Classification of Diseases (ICD).

The ICD system

The World Health Assembly, the governing body of the World Health Organization (WHO), established the ICD to serve as a “standard diagnostic tool for epidemiology, health management, and clinical purposes.” Many countries use ICD to report mortality data and it is available officially in Arabic, Chinese, English, French, Russian, and Spanish.¹

Outdated ICD-9

The new code changes in ICD-10 are intended to clarify coding and resolve some of the challenges presented by ICD-9. Out-of-date medical terminology is removed and ICD-10 ensures that no procedure has more than one code.

ICD-9 is an older system created in 1978 and based initially on the medical knowledge of that period. First developed in 1995, ICD-10 is much newer and has room for new codes.

ICD-10 code structure

Each code has between three and seven alphanumeric characters, replacing ICD-9’s three to five characters. Thanks to the additional characters in each code, there are more possible code combinations with ICD-10 for future diagnostic codes to be added.

ICD-10 codes are divided into two separate categories. Diagnosis codes are included in ICD-10-CM, while hospital inpatient procedures are coded in ICD-10-PCS. These new codes capture more detail than the previous system, with information such as the side of the body affected by the condition and whether healing is routine or delayed.

This greater detail assists with reporting public health information and documenting specific health information for use by different healthcare teams.

Assess your system

We’ve made it to the ICD-10 change and ideally, your preparation began before now. The Centers for Medicare and Medicaid Services (CMS) has a website dedicated to ICD-10 preparation with more information about how ICD-10 affects your practice.

Now is a good time to assess your system and work out any kinks.

• Work with your EHR vendor to assess how they are set up for ICD-10, and how they plan to assist your practice moving forward. Doing so will identify your EHR vendor as a resource or not.
• Your staff may need ongoing training, and at the very least, staff members should be aware of basic information about the coding transition, how it is different, and how it impacts their job functions. Encourage staff to review the CMS website and bookmark any information that is especially helpful.
• Any paperwork used in your office should reflect the new coding system, as should your paper-based patient records, if you use any paper documents in your practice. Update these now if you have not already.
• If you are in any organizational partnerships, it is particularly important to ensure that your partners are ready too. Work together with your software vendors, billing and coding contractors, and any other vendors or partners you regularly involve in the billing and coding process. Report errors immediately to work out solutions as inconsistencies arise.

Yes, ICD-11 is being developed

In May of 2012, WHO launched an ICD-11 Browser, or “ICD-10 Beta Draft.” Anyone can access, review, and submit suggestions for the latest developments. It is still accessible as of September 2015, and all you need to do is register with their website.

The website asserts ICD-11 Beta Draft is not final or approved, updated daily, and not to be used for coding yet.

WHO completed their first external review of the ICD-11 Revision with the hopes of publishing it in 2018. Ongoing updates of ICD coding will occur as more diseases are discovered and disease classification becomes more refined.

Preparing for change

If you made a great preparation plan for your practice to transition to ICD-10, keep it around for the next update. If your transition plan needs some work, it is not too late, and you will use it for future iterations of ICD.

Preparing for change is your best tool on your road to success. Know what’s ahead and you won’t have any trouble keeping up.

References

¹ World Health Organization. “Classifications: International Classification of Diseasea (ICD).” http://www.who.int/classifications/icd/en/. Accessed September 2015.