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Don’t Be Afraid of ICD-10 Embrace the ICD-10 Delay

Don’t Be Afraid of ICD-10 Embrace the ICD-10 Delay. Melonie Loutsch, CPC, ACS-EM April 26 th 2014. ICD-10 Delay. A one-year delay of ICD-10 has been implemented. New target date for ICD-10 is October 1, 2015 Second time congress has acted to delay ICD-10. The start of ICD.

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Don’t Be Afraid of ICD-10 Embrace the ICD-10 Delay

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  1. Don’t Be Afraid of ICD-10Embrace the ICD-10 Delay Melonie Loutsch, CPC, ACS-EM April 26th 2014

  2. ICD-10 Delay • A one-year delay of ICD-10 has been implemented. • New target date for ICD-10 is October 1, 2015 • Second time congress has acted to delay ICD-10.

  3. The start of ICD • The classification system started in 1850 and was known as the International list of cause of death. • 1883 the classification system was know as International Statistical Institute. • 1948 the World Health Organization (WHO) took over the responsibility for this classification system better known as ICD (International Classification of Disease).

  4. Why Convert to ICD-10 Now? • ICD-9 has been around since 1978. • 1990 the WHO endorsed ICD-10 to the world and many countries adopted it but the United States. • Because of the age of ICD-9 it doesn’t accurately reflect all the advances in medical technology and medical knowledge.

  5. Why Convert to ICD-10 Now • ICD-9 is simply running out of codes with no room for expansion within the current 17 chapters. • ICD-9 is also lacking the increased specificity that ICD-10 has.

  6. ICD-10 Specificity With ICD-10 having higher specificity of codes it is believed that with more specific data • I10 will provider better information to identify diagnosis trends. • I10 will provider better information for public health needs. • I10 will provider better information to understand epidemic outbreaks. • I10 will provider better information on how to deal with bioterrorism events.

  7. ICD-10 Specificity With I10 having more precise codes we will have • The potential benefit for fewer rejected claims. • Improved benchmarking data. • Improved quality and care management. • Improved public health reporting.

  8. Grieving Process of ICD-10 • Denial Stage – This can’t be happening • Anger Stage – It is not fair what is the government thinking. • Bargaining Stage – “Dear Lord if I10 doesn’t happen I will never complain about work again”. • Depression Stage – I am never going to be able to learn this. I’m to old for this. • Acceptance Stage – I learned ICD-9 I can learn ICD-10. It is going to be ok.

  9. ICD-10 Not a Simple Update • ICD-10 is not a simple update to ICD-9 but a whole fundamental change in the structure and concepts that make ICD-10 very different from ICD-9

  10. Comparison Table

  11. ICD-10 Chapters • Chapter 1 - Infectious and Parasitic Disease • Chapter 2 - Neoplasms • Chapter 3 – Disease of Blood • Chapter 4 – Endocrine and Nutritional Disease • Chapter 5 – Mental Disorders • Chapter 6 - Disease of Nervous Systems • Chapter 7 – Disease of Eye and Adnexa (new)

  12. ICD-10 Chapters • Chapter 8 - Disease of Ear and Mastoid (new) • Chapter 9 – Diseases of Circulatory System • Chapter 10 – Disease of Respiratory System • Chapter 11- Disease of the Digestive System • Chapter 12 – Disease of Skin • Chapter 13- Disease of Musculoskeletal System

  13. ICD-10 Chapters • Chapter 14 – Disease of Genitourinary System • Chapter 15 – Pregnancy and Childbirth • Chapter 16 – Perinatal Period • Chapter 17 – Congenital and Malformations • Chapter 18 – Symptoms, Signs, and Abnormal Clinical laboratory findings.

  14. ICD-10 Chapters • Chapter 19 – External Causes of Injury and Poisoning • Chapter 20 – External Causes of Morbidity • Chapter 21 – Factors Influencing Health Status and Contact with Health Services.

  15. ICD-10 Code Structure • Characters 1-3 – Category Codes • Characters 4-6 – Etiology, anatomic site, severity, or other clinical detail. • Character 7 - Extension

  16. Code Structure

  17. Documentation Readiness for ICD-10 • Specificity- In ICD-10 they type of tobacco product being used is part of of the code choice selection and documentation should include this • Clinical Support Documentation – BMI is coded secondarily to obesity and documentation needs to include BMI for proper code choice selection

  18. Be Ready for ICD-10 • Combination Codes – Diabetes Mellitus codes are now combination codes that include manifestations requiring documentation of any manifestation as well as the type of DM. • Insulin Use – Long term use of insulin is coded for any Type 2 diabetic patient on insulin. • Simplification – Immunization coding is simplified to 1 code.

  19. Be Ready for ICD-10 • Type – Documentation for upper respiratory infections needs to include acute, chronic, due to streptococcal or viral NOS in order to assign the most appropriate code. • Cause – ICD-10 Obesity is classified due to drug, excess calories, and then further divided by morbid and sever.

  20. What do Provider need to do • Think in ink • Let your documentation show what you are treating, managing, or reviewing • Put it all in ink so that we can code to the highest specificity.

  21. Team Work • More now than any other time the medical tem must work together. • Clinic, hospital, or nursing home • With the move from ICD-9 to ICD-10, Meaning full use, and the ACOS. We need team work to encourage each other.

  22. Don’t be afraid ICD-10 • Instead of being afraid of ICD-10 we need to embrace it and forge ahead. It is the same as trying to eat and elephant. Just take one bit at a time.

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