Implementation of ICD-10
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The document outlines the history and benefits of the ICD-10 coding system, which was developed to replace the outdated ICD-9 codes. It details the adoption timeline, comparisons between ICD-9 and ICD-10, and the necessary training and compliance steps for healthcare professionals. Ultimately, ICD-10 aims to enhance healthcare data quality, reimbursement processes, and public health monitoring with greater detail and accuracy.
![Other countries that have implemented ICD-10 recommend:
€Do not procrastinate.
€Use all the time available and prepare well.
€Begin training coders 6 months in advance of implementation.
€Communicate with others at facility and with vendors.
€Transition leaders should prepare for issues related to ICD-9 and ICD-10 for documenting, movement, and comparisons.
(“ICD-10: Ready or Not,” n.d. [Image]). (“ICD-10-CM and ICD-10-PCS,” n.d.).](https://image.slidesharecdn.com/implementationoficd-10final-141117141504-conversion-gate02/85/Implementation-of-ICD-10-15-320.jpg)
![References
Centers for Disease Control and Prevention. (2011, March 1). International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM).Retrieved from http://www.cdc.gov/nchs/icd/icd10cm.htm
Centers for Medicare & Medicaid Services. (2010, December 6). MLN Matters Number SE1019 Revised. Retrieved from http://www.cms.gov/MLNMattersArticles/downloads/SE1019.pdf
Centers for Medicare & Medicaid Services. (2011, March 21). ICD-10 and Version 5010 Compliance Timelines. Retrieved from http://www.cms.gov/ICD10/03_ICD- 10andVersion5010ComplianceTimelines.asp
“ICD-10: Ready or Not, Here It Comes.” [Title Image]. (n.d.). Retrieved May 8, 2011, from http://www.icd10codes.com/ICD_10_Codes_Article_1.html
“ICD-10-CM and ICD-10-PCS-Frequently Asked Questions.” (n.d.). HIM and Patient Financial Services from 3M Health Information Systems. Retrieved May 8, 2011, from Leadershttp://multimedia.3m.com/mws/mediawebserver?mwsId=66666UuZjcFSLXTtnXTVMXfyEVuQEcuZgVs6EVs6E666666--&fn=icd10_public_FAQs_him_pfs.pdf—
Reynolds, A. (2009, November 27). Retrieved from http://www.hcim.com/2009/11/the-history-of-icd- 10/
“The Differences Between ICD-9 and ICD-10.” (2010, June 2). Retrieved May 8, 2011, from http://www.ama-assn.org/ama1/pub/upload/mm/399/icd10-icd9-differences-fact-sheet.pdf](https://image.slidesharecdn.com/implementationoficd-10final-141117141504-conversion-gate02/85/Implementation-of-ICD-10-16-320.jpg)
Implementation of ICD-10
- 1. Implementation of ICD-10 Debra Jones HIT245-06: Phase 5 Individual Project May 8, 2011
- 2. History of ICD-10 Adoption The ICD (International Classification of Diseases) is the international standard diagnostic classification for: €All general reasons related to the study and causes of disease €Clinical use €Numerous health management principles This classification includes: €Investigating groups of people of common medical conditions €Observing the occurrence and regularity of diseases €Observing other medical issues related to other irregularities such as traits of affected persons, resource distribution, reimbursement, quality, and procedures (Reynolds, 2009)
- 3. History of ICD-10 Adoption, Cont’d Since 1979, ICD-9 code sets have been used and revised yearly. In May 1990, the 43rdWorld Health Assembly approved ICD-10. In 1994, ICD-10 came into use in WHO (World Health Organization) member states. The United States is one of only a few developed countries that has not changed over to ICD-10-CM and ICD-10-PCS. (Reynolds, 2009)
- 4. History of ICD-10 Adoption, Cont’d Department of Health & Human Services (HHS) recommended in August 2008 that new code sets be used in the United States for documenting diagnoses and procedures on medical transactions. August 22, 2008, this Proposed Rule was made public for evaluation. January 15, 2009, a final rule was instituted announcing ICD-10 as the new national coding standard. The completion date has been set for October 1, 2013. (Reynolds, 2009)
- 5. Comparison of ICD-9 to ICD-10 ICD-9 Diagnosis Codes ICD-10 Diagnosis Codes 3 to 5 digits long 3 to 7 digits long About 13,000 codes About 68,000 codes are available First digit is V or E code or a number, and digits 2 through 5 are numbers Digit 1 is a letter; digits 2 and 3 are numbers, and digits 4 through 7 are either letters or numbers Restricted amount of room for addition of new codes Accommodating to the addition of new codes Detail is lacking Very precise Laterality is deficient Laterality is displayed (codes relating right versus left) (“The Differences Between ICD-9 and ICD-10,” 2010).
- 6. Comparison, Cont’d ICD-9 Procedure Codes ICD-10 Procedure Codes 3 to 4 digits long 7 digits long, letters and numbers About 3,000 codes About 87,000 codes are available Outdated technology Up to date medical terminology Inadequate space for adding new codes Able to handle addition of new codes Detail and laterality is lacking Very precise and laterality is displayed Generic terms for body parts Precise terms for body parts Methodology and approach for procedures lacks detail Precise descriptions of methodology and approach for procedures Lack of detail to sufficiently describe procedures Specifically describes procedures related to method, body part, device, and required criteria (“The Differences Between ICD-9 and ICD-10,” 2010).
- 7. Benefits of ICD-10 ICD-10 will replace the old, ICD-9 classification system and provide superior data required to: €Determine quality, safety, and usefulness of care €Diminish need for further explanation of patient’s condition €Create payment systems and process claims for reimbursement €Perform research, clinical trials, and epidemiological studies (Centers for Medicare & Medicaid, 2010)
- 8. Benefits of ICD-10, Cont’d €Establish medical policy €Support operational and strategic planning €Create healthcare delivery systems €Track resource operation €Enhance performance of financial, clinical, and administrative operation €Thwart and identify healthcare deception and abuse €Monitor public health and dangers (CMS, 2010).
- 9. National Adoption Dateand Requirements ICD-10-CM is now available to the public. These codes are not for current use however. The date of operation for ICD-10-CM and ICD-10-PCS is October 1, 2013 Updated versions will be made before this date. (Centers for Disease Control and Prevention, 2011).
- 10. Date Compliance Step January 1, 2010 Internal testing of Version 5010 principles for electronic claims should be started by payers and providers December 31, 2010 Internal testing of Version 5010 needs to be complete in order to be in compliance with Level I Version 5010 January 1, 2011 External testing of Version 5010 for electronic claims should begin by payers and providers Version 5010 claims will start to be accepted by CMS Version 4010 claims will still be accepted Timeline (Centers for Medicare & Medicaid Services, 2011).
- 11. Date Compliance Step December 31, 2011 External testing of Version 5010 for electronic claims must be done in order to be in compliance with Level II Version 5010 January 1, 2012 Version 5010 must be used for all electronic claims No longer will Version 4010 claims be accepted October 1, 2013 ICD-10 codes for diagnoses and inpatient procedures must be used on all claims for services given from this date forward Outpatient services will still be coded using CPT codes Timeline, Cont’d (CMS, 2011).
- 12. Internal testing begins January 1, 2010 External testing begins for electronic claims by January 1, 2011. Version 5010 will be used on all electronic claims by January 1, 2012,and 4010 claims will no longer be accepted. Internal testing is complete for Level I by December 31, 2010 External testing of Level II is complete and in compliance by December 31, 2011. ICD-10 Only to be used on claims from October 1, 2013, forward. Outpatient services will still be assigned with CPT codes. 2010 2011 2013 2012 ICD-10 and Version 5010 Timeline (CMS, 2011).
- 13. Training for ICD-10 An HIM (Health Information Management) department leader needs to: €Participate in a committed position on ICD-10 teams €Instruct executives and team members €Figure out educational needs of the department €Keep apprised of ICD-10 happenings on the national level €Partner with IT department to set up HIM systems €Develop documentation and query procedures to focus on the precise details of ICD-10 (“ICD-10-CM and ICD-10-PCS,” n.d.)
- 14. Training for ICD-10, Cont’d €Provide training to coders through AHIMA or other professional organizations €Ensure that coders know how to document according to the changes in the new code set €Expect a more thorough knowledge of medical terminology from coders since there is so much more detail involved in ICD-10 (“The Differences Between ICD-9 and ICD-10,” 2010).
- 15. Other countries that have implemented ICD-10 recommend: €Do not procrastinate. €Use all the time available and prepare well. €Begin training coders 6 months in advance of implementation. €Communicate with others at facility and with vendors. €Transition leaders should prepare for issues related to ICD-9 and ICD-10 for documenting, movement, and comparisons. (“ICD-10: Ready or Not,” n.d. [Image]). (“ICD-10-CM and ICD-10-PCS,” n.d.).
- 16. References Centers for Disease Control and Prevention. (2011, March 1). International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM).Retrieved from http://www.cdc.gov/nchs/icd/icd10cm.htm Centers for Medicare & Medicaid Services. (2010, December 6). MLN Matters Number SE1019 Revised. Retrieved from http://www.cms.gov/MLNMattersArticles/downloads/SE1019.pdf Centers for Medicare & Medicaid Services. (2011, March 21). ICD-10 and Version 5010 Compliance Timelines. Retrieved from http://www.cms.gov/ICD10/03_ICD- 10andVersion5010ComplianceTimelines.asp “ICD-10: Ready or Not, Here It Comes.” [Title Image]. (n.d.). Retrieved May 8, 2011, from http://www.icd10codes.com/ICD_10_Codes_Article_1.html “ICD-10-CM and ICD-10-PCS-Frequently Asked Questions.” (n.d.). HIM and Patient Financial Services from 3M Health Information Systems. Retrieved May 8, 2011, from Leadershttp://multimedia.3m.com/mws/mediawebserver?mwsId=66666UuZjcFSLXTtnXTVMXfyEVuQEcuZgVs6EVs6E666666--&fn=icd10_public_FAQs_him_pfs.pdf— Reynolds, A. (2009, November 27). Retrieved from http://www.hcim.com/2009/11/the-history-of-icd- 10/ “The Differences Between ICD-9 and ICD-10.” (2010, June 2). Retrieved May 8, 2011, from http://www.ama-assn.org/ama1/pub/upload/mm/399/icd10-icd9-differences-fact-sheet.pdf