ICD-10, Ready or Not

ICD-10, Ready or Not

by abilling, September 15, 2015

October 2015

Be more clinically specific.  ICD 10 requires more knowledge in Anatomy & Physiology, Medical Terminology, Pharmacology, and Medical Science, thus expecting more details when reporting.

  • 13,000 ICD 9 diagnosis codes expand to 69,000 ICD 10 diagnosis codes
  • 25% of ICD 9 CM diagnosis codes have an exact match to ICD 10 CM
  • 3% ICD 9 have no match to ICD 10
  • 12% of ICD 10 have no match to ICD 9

Codes now reference (for example);

Type: Describes a condition

Malignant, neoplasm, pathological fracture

Temporal factors: relates to a condition to a particular time parameter

Acute, chronic, recurrent

Cause or Contributing factors: describes any contributing factors to the current condition

Allergy, history of tobacco use, infection, trauma

Symptoms, findings, manifestations: describes symptoms as a result of the condition

Insomnia, tenderness, vomiting

Anatomy: identifies the anatomical location related to the condition

Femur, knee, maxillary, ulna

External cause; identifies the cause of injury, poisoning or other consequence of an external factor

Locations of laterality: related to the location of the body

Bilateral, left, right, upper, lower

Complications: any factors that have complicated the condition

Episode: initial, sequel, subsequent

 

Remember documentation and complete descriptions are key for proper coding.  Proper coding is required for proper billing and proper billing equates to proper payment.

 

 

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abinsights readers are invited to submit comments, questions, tips, and suggestions for articles on any subject related to billing, collections, coding, reimbursement, and compliance.  Send to:  Anesthesia Billing, Inc.,     P O Box 388, Newton, KS  67114-0388.  Phone 316-281-3700.  Fax 316-282-4322.

Our purpose is to help you meet inevitable challenges.  We hope to deliver practical knowledge and solutions drawn from top resources and business publications in every issue, knowledge you can use today.

Reasonable attempts have been made to be accurate.  However, medical billing, collections, coding and compliance are part science, part art, and even experts sometimes differ.  Neither Anesthesia Billing, Inc., the editors, publisher, contributors, or consultants warrant or guarantee the information contained will be applicable or appropriate in all situations.  For information specific to your practice, consult a qualified professional.

The information included in this publication is provided, among other things, to alert you to legal developments and should not be considered legal advice.  Specific questions about how this information affects your particular situation should be addressed to your attorney.

Editor:  Philip Blann (pblann@anesthesiabilling.com).

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