confidential & proprietary icd-10. background icd-10 is part of health care reform and is the...
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confidential & proprietary
ICD-10
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Background
ICD-10 is part of Health Care Reform and is the coding World Standard.
The US is only industrialized nation not using ICD10.
WHO utilizes it to analyze epidemics and health trends
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Disadvantages of ICD-9
ICD-9 has been around for 30 years
Not Current
Doesn’t reflect current understanding of diseases
Cannot be updated easily
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Advantages of ICD-10
ICD-10 uses updated terminology
Greater level of detail within the codes
Enhanced accuracy and specificity
Provides increased flexibility
Supports new and refined reimbursement and payment models
Allows for better fraud detection and investigation
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Specific
• Body System• Body Part
Characters
• Each character is independent
• The value is the same across the code set
Terminology
• All terms have same meaning in both code sets
Code Sets are Uniform
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Clinical Management Codes (CM)
=Diagnosis Codes
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1 2 3 4 5 6 7
S 8 2. 8 4 4 ANondisplaced bimalleolar fracture of right lower leg, initial encounter for closed fracture
824.4Bimalleolar fracture
ICD-10-CM:
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Alcohol Abuse and DependencyICD9 - 14 codes
ICD10 - 46 codes
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Procedural Coding System
Codes (PCS)=
ICD Procedure Codes
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1 2 3 4 5 6 7
Section
Body system
Root operation
Body part
ApproachDevice
Qualifier
Med/Surg GI system Resection Appendix Perc/Endoscopic None None
0 D T J 4 Z Z
ICD-10: Laparoscopic Appendectomy 0DTJ4ZZ
47.01Laparoscopic
AppendectomyICD-10-PCS:
ICD-9:
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Repair of skin and subcutaneous tissue
ICD9 – 1 codeICD10 – 21 codes