ICD-10 Overview | Highlights & New Features

Posted on 10.15.2013

Medical coders everywhere are getting ready for the transition to from the ICD-9 to the ICD-10 code set next year. The Center for Medicare and Medicaid Services (CMS) has mandated that all healthcare facilities and payers must begin using the ICD-10 code set on October 1, 2014. With less than a year left to prepare, it’s important to understand what some of the big differences are.

Of course with a change from about 17,000 ICD-9 codes to over 155,000 ICD-10 codes there are LOTS of changes. But to give you a quick overview, we’ve put together a few highlights.

ICD-10 Highlights
ICD-10 is being published in two books—International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM) and International Classification of Diseases, 10th revision, Procedure Coding System (ICD-10-PCS).  ICD-10 codes will be officially implemented in the United States October 1, 2014. These codes will replace International Classification of Diseases, Ninth Revision, Clinical Modifications Volumes 1 and 2 for diagnosis codes, and the International Classification of Diseases, Ninth Revision, Clinical Modification Volume 3 for procedure codes.

The new code set allows for more categories of diseases and other health-related conditions. Additionally, more codes will now be available to specify laterality with additional characters added to the code set.

There are a few important comparisons that we can make between the ICD-9 and ICD-10 Clinical Modification codes:

  • ICD-9-CM has 17 chapters of codes; ICD-10 has 21 chapters
  • ICD-9-CM codes are 3-5 characters in length; ICD-10-CM codes are alphanumeric and can be up to 7 characters long
  • ICD-10-CM still has an Alphabetic Index and a Tabular List, similar to the set-up of ICD-9-CM

Features that are new to ICD-10-CM include:

  • Added laterality
  • Expanded codes
  • Added seventh-characters for episode of care
  • Combination codes for conditions and common symptoms or manifestations
  • Combination codes for poisonings and external causes
  • Addition of “X” placeholder
  • Two types of excludes notes are now referenced
  • Time frame changes (acute myocardial infarction changed from 8 weeks to 4 weeks)
  • Trimester are now included in obstetric codes

ICD-10-PCS provides a unique code to each substantially different procedure.  The code system is expandable, so as new procedures are developed new codes can be added.  Each code character has the same meaning within a specific procedure section—a multi-axial structure— and each term in the Procedural Classification System (PCS) has a specific meaning, providing standardization.

Comparisons we can make between the ICD-9 and ICD-10 Procedural Classification System include:

  • ICD-9 procedure codes can be 3 or 4 digits; ICD-10-PCS must be 7 characters
  • ICD-9 procedure codes contain a decimal point; ICD-10-PCS does not
  • ICD-9 procedure codes are numeric; ICD-10-PCS are alphanumeric

New Features
ICD-10-PCS is comprised of 3 sections: the tables, the index, and the list of codes. The purpose of the index is to locate the correct table.  It is not necessary to reference the index before referencing the tables to assign the correct code.

PCS codes must have 7 characters, one for each of the following:

  • Section
  • Body System
  • Root Operation
  • Body Part
  • Approach
  • Device
  • Qualifier

We’re looking forward to ICD-10—are you?

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