ICD-10
This week I continued my monthly series featuring experts from Medical Association of Georgia. Our conversation focused on the upcoming implementation of ICD-10 codes, which will significantly change how we document and are reimbursed for care provided to our patients.
I sat down with Dr. James Dunnick, a former practicing cardiologist of over 25 years who began to enhance his level of understanding of coding, compliance, and quality review later in his career. He now provides consulting services to healthcare practices and hospitals on these important components of their businesses.
Within the healthcare industry, providers, coders, IT professionals, insurance carriers, government agencies, and others use ICD codes to properly note diseases on health records, track epidemiological trends and assist in medical reimbursement decisions.
The World Health Organization (WHO) owns, develops, and publishes ICD codes, and national governments and other regulating bodies adopt the system.
The differences between ICD-9 and ICD-10 are significant and physicians and practice management staff need to start educating themselves now about this major change so that they will be able to meet the ICD-10 compliance deadline of October 1 – in less than one month.
ICD-10-CM codes are the ones designated for use in documenting diagnoses. They are 3-7 characters in length and total 68,000, while ICD-9-CM diagnosis codes are 3-5 digits in length and number over 14,000. The ICD-10-PCS are the procedure codes and they are alphanumeric, 7 characters in length, and total approximately 87,000, while ICD-9-CM procedure codes are only 3-4 numbers in length and total approximately 4,000 codes. ICD-10-PCS is only used for coding hospital inpatient procedures. CPT remains the code set for reporting procedures and services in offices and outpatient settings.
Moving to ICD-10 is expected to impact all physicians. Due to the increased number of codes, the change in the number of characters per code, and increased code specificity, this transition will require significant planning, training, software/system upgrades/replacements, as well as other necessary investments.
WHO is expected to release ICD-11 in 2017.
Special Guest:
Dr. James Kennedy, MD, of
Within the healthcare industry, providers, coders, IT professionals, insurance carriers, government agencies, and others use ICD codes to properly note diseases on health records, track epidemiological trends and assist in medical reimbursement decisions.
The World Health Organization (WHO) owns, develops, and publishes ICD codes, and national governments and other regulating bodies adopt the system.
The differences between ICD-9 and ICD-10 are significant and physicians and practice management staff need to start educating themselves now about this major change so that they will be able to meet the ICD-10 compliance deadline of October 1 – in less than one month.
ICD-10-CM codes are the ones designated for use in documenting diagnoses. They are 3-7 characters in length and total 68,000, while ICD-9-CM diagnosis codes are 3-5 digits in length and number over 14,000. The ICD-10-PCS are the procedure codes and they are alphanumeric, 7 characters in length, and total approximately 87,000, while ICD-9-CM procedure codes are only 3-4 numbers in length and total approximately 4,000 codes. ICD-10-PCS is only used for coding hospital inpatient procedures. CPT remains the code set for reporting procedures and services in offices and outpatient settings.
Moving to ICD-10 is expected to impact all physicians. Due to the increased number of codes, the change in the number of characters per code, and increased code specificity, this transition will require significant planning, training, software/system upgrades/replacements, as well as other necessary investments.
WHO is expected to release ICD-11 in 2017.
Special Guest:
Dr. James Dunnick, MD, of SESEDN, LLC and The Dunnick Group, LLC
- Board Certified Cardiologist with 25 years of clinical practice
- Certified Professional Coder (CPC) through the American Academy of Professional Coders (AAPC)
- Certified in Quality and Utilization (CHCQM) by the American Board of Quality Assurance, Utilization Review Physicians (ABQAURP)
- Certified in Compliance (CMDP) by the American Institute of Healthcare
