For physicians with an inclination for procrastination, the October 1, 2014 deadline for transitioning to ICD-10-CM may come as a rude awakening.

April 17, 2012

3 Min Read
Live from AANS: Charting New Medical Territory with ICD-10


For physicians with an inclination for procrastination, the October 1, 2014 deadline for transitioning to ICD-10-CM may come as a rude awakening. But neurosurgeons attending this year’s AANS Annual meeting have been given ample warning, thanks to Dr. John Ratliff’s presentation, “What Neurosurgeons Need to Know Now to Prepare.”


The International Classification of Diseases, or ICD, is the international standard diagnostic classification for all general epidemiological, and many health management and clinical purposes.


Right now, physicians in the United States use the 9th edition of ICD (ICD-9-CM), the version developed by the WHO and that’s been in place since 1979. However, with new medical discoveries and advances in technology, ICD-9-CM can no longer capture the complexity of modern diagnoses and procedures.


One of the reasons that HHS has mandated the replacement of the ICD-9-CM code sets is because it’s maxed out. ICD classifications are organized scientifically, with three-digit categories that have only 10 subcategories. Since the majority of numbers in most categories are already assigned to medical diagnoses, it’s difficult to find available numbers to attach to new medical diagnoses.


The new, more detailed codes of ICD-10-CM will resolve this and allow for better analysis of disease patterns and treatment outcomes. The additional details are also meant to make initial claims easier for payers to understand, ideally streamlining claims submissions.


“A good result of ICD-10 will be that there will be a lot more information and data provided about patients’ overall health quality and disease states,” explains Ratliff, MD, FACS, Associate Professor and codirector of spine and peripherial nerve surgery at Stanford University Medical Center. “But in terms of capturing and delivering that data, the reality is that it’s going to be a heavy load on a lot of physicians, especially small physician groups that may not have the resources to seamlessly make this shift.”


In the transition to ICD-10-CM, every single diagnosis code that physicians have been using since ICD-9-CM was adopted has to change, and every procedural billing has to be modified.


To ensure minimal disruption to the physician’s practice and payments, Ratliff recommends that doctors start planning now for ICD-10-CM implementation. This mainly involves ensuring that they and their staff receive adequate training and that their EMR (electronic medical records) system will translate easily from ICD-9-CM to ICD-10-CM.


“Having the right technology is definitely a part of it, but it will also be important for physicians to quickly adapt to providing a lot more information in their diagnoses descriptions,” Ratliff says. “For example, instead of just coding ‘cervical spinal cord injury,’ with ICD-10, physicians will need to include what level it is (C1, C2, C3), what kind of spinal cord injury it is, if it’s associated with a fracture, etc. This is much more information than what is required now.”


With the number of diagnostic codes under ICD-10-CM increasing from 13,500 to 69,000 and inpatient procedures jumping from 4,000 codes to 71,000 codes, the change to ICD-10-CM will be the most challenging transition since the inception of coding.


What are your thoughts? Do you feel prepared to integrate ICD-10-CM into their practices? How do you anticipate ICD-10 will affect your productivity?


Tricia Rodewald is marketing director at Pro-Dex Inc. (Irvine, CA).

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