Key differences between ICD-9 and ICD-10?
Many, many more codes.
With a nearly fivefold increase from 14,000 diagnosis codes to over 69,000, and a nearly 19-fold increase from almost 4,000 procedure codes to almost 72,000, the transition from ICD-9 to ICD-10 can seem overwhelming.
Specialties affected differently
While many of the ICD-10 codes are built upon existing ICD-9 codes, some codes are significantly different than ICD-9. Similar diagnoses may have completely different codes. Specialties such as obstetrics, psychiatry, and emergency medicine, along with specialties that deal with musculoskeletal disease and injuries, will encounter disproportionately significant changes.
ICD-10 codes will be longer to allow for greater specificity and for more flexibility to add new codes. ICD-10 has alphanumeric categories instead of numeric ones. The order of some chapters have changed, some titles have been renamed, and conditions have been grouped differently.
|Comparison of Diagnosis Code Sets|
|3-5 Characters in length||3-7 Characters in length|
|First character may be alpha or numeric, characters 2-5 are numeric||Character 1 is alpha; Characters 2 and 3 are numeric; characters 4-7 are alpha or numeric|
|Less specificity||Greater specificity|
|Laterality not specified||Laterality specified (e.g. left versus right)|
|Limited space for new codes||Flexibility to add new codes|
|ICD-10-CM Code Structure|
|Characters 1 through 3 – Category|
|Characters 4 through 6 – Etiology, anatomic site, severity, or other clinical detail|
|Character 7 – Extension|
|ICD-10-CM Code Detail|
|S52 Fracture of the forearm|
|S52.3 Fracture of the shaft of the radius|
|S52.32 Transverse fracture of the shaft of the radius|
|S52.321 Displaced transverse fracture of the shaft of the right radius|
|S52.321A Displaced transverse fracture of the shaft of the right radius,initial encounter for closed fracture|
How an EHR helps you
The biggest worry providers have is that they or their coders will need to learn so many new ICD-10 codes and standards that they will make mistakes, resulting in claim denials. Incorrect coding can mean the difference between full reimbursement and no reimbursement.
Cloud-based EHRs will fare better
Medical professionals who use cloud-based EHRs and billing services should fare better during this transition. Since mappings from ICD-9 to ICD-10 are not one-to-one, electronic tools like EHRs help guide users to the appropriate ICD-10 diagnosis and, in some cases, automate the conversion from one code-system to another. This helps ensure that users are selecting the most specific, billable, ICD-10 code for a particular diagnosis category.
Practice Fusion has the tools you need
To this end, Practice Fusion aims to fully support your practice through this transition with tools that provide ICD-10 translation support, directly within your EHR workflows. We plan to release additional tools, well in advance of the ICD-10 deadline on October 1, 2015, to help you eliminate the need to memorize the differences or to hire a new billing service to handle the work of cross-walking your codes. These tools will walk you through the new ICD-10 coding process, so you can easily learn the codes as you work while avoiding disruption to your workflow. Think of it as an ICD-9/SNOMED to ICD-10 crosswalk.
You will also need a billing partner who is also prepared for the ICD-10 transition. This will ensure that you get the proper notification for codes that may not be valid for billing. All of our preferred billing partners should be ICD-10 ready and prepared to provide you the notifications you need to ensure success in your EHR and in the billing software of your choice.
Once this functionality is released, you will have the opportunity to test out your existing ICD-9 codes to make sure that you are identifying the correct ICD-10 code.