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ICD-10

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

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

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

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

Clinical Management Codes (CM)

=Diagnosis Codes

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:

Alcohol Abuse and DependencyICD9 - 14 codes

ICD10 - 46 codes

Procedural Coding System

Codes (PCS)=

ICD Procedure Codes

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:

Repair of skin and subcutaneous tissue

ICD9 – 1 codeICD10 – 21 codes