ICD-10 Training: Ensure a Smooth ICD-10 Transition


 

ICD-10 is the major change in Medical Billing in 25 years. Read this ICD 10 training article and know what you are you required to do to make a smooth transition.

If any of you happen to do a facility coding, you are in for quite a treat because there were no DRG codes in ICD-10. The codes are all options. So for example there's an option for endoscopic surgery and option for percutaneous surgery, open surgery or no surgery.

There's an option for a monitoring device and infusion device or no device. There's an option for diagnostic treatment or treatment services. You use these different options to bill the unique code for every patient that enters your facility. In format ICD-10, they're capital letters followed by two alphanumeric characters then a decimal .0 and 0 to 4 alphanumeric characters after that. The alphanumeric characters are either numbers or lower case letters.

For example, M1a.0111 is idiopathic chronic gout of the right shoulder with tophus. ICD 10 diagnoses codesare organized a little bit differently than ICD-9s and they use a different hierarchy for choosing multiple codes. In fact ICD 10 codes really don't resemble ICD-9s in any way, shape or form.

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This truly is the biggest change in medical billing in 25 years. And for a lot of people, it's going to be a lot like going back to kindergarten and learn to read and write all over again because you know the ICD-9s from memory.

The way you use ICD-10s and the ICD-10 book is the same but the codes themselves are incredibly different. One of the major differences is that ICD10 codes are coded based on the underlying cause of a condition. So infective arthritis is no longer coded as arthritis by an infective agent also list the code for the infective agent like it is an ICD-9.

In ICD-10, it's coded by the infecting organism venous arthritis. It's the exact opposite. Now there is a code for unspecified arthritis. But many insurance carriers are taking the stands that ICD-10 contains enough detail. It shouldn't be necessary to use unspecified medical codes.

And if you've been treating a patient for five years and you still don't know what kind of arthritis they have, you're probably not providing very good quality of care. And insurance carriers are no longer going to pay for suboptimal care.

Now we all know that physician knows what kind of arthritis the patient has. It's just easier to say arthritis than to say osteoarthritis or staph induced arthritis. And we also know how easy it is to get a physician to change their habits sometimes.

The problem here is that even if you get your physician to tell you the patient has osteoarthritis, that too is an unspecified code you need the location.

And even if you get your physician to tell you that it is generalize osteoarthritis, that is also an unspecified code as per medical coding guidelines. You need to know if it's primary, secondary or erosive. An osteoarthritis and osteoarthropathy are no longer the same ICD codes in ICD-10. They are in ICD-9.

And because ICD-10 codes are in mixed up upper and lower case letters, there's always going to be a little more charge entry time required because your staff has to keep hitting that shift key repeatedly, unless your computer vendor can automate that field.

The World Health Organization actually issues the ICD codes. The CM subset is what's used in the US and that's selected by the Department of Health and Human Services.

The World Health Organization endorsed ICD-10 in 1990. The United States is the only industrialized country not currently using them. So the chances of this change being revoked are very, very slim.

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