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Preparing for ICD-10-CM for Pathology Practices

Preparing for ICD-10-CM for Pathology Practices. Presented by Cindy Hegner, CCS CUG 2011. What We Will Cover. When will we start using ICD-10 Who needs to be familiar with ICD-10 Staff Education Costs Comparing ICD-9 with ICD-10 New features of ICD-10

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Preparing for ICD-10-CM for Pathology Practices

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  1. Preparing for ICD-10-CM forPathology Practices Presented by Cindy Hegner, CCS CUG 2011

  2. What We Will Cover • When will we start using ICD-10 • Who needs to be familiar with ICD-10 • Staff Education Costs • Comparing ICD-9 with ICD-10 • New features of ICD-10 • A brief summary of the Chapters of ICD-10 • Recommended web sites and reference books

  3. THE BIG QUESTION Will the Effective Date of ICD -10-CM be extended? Answer: No. At the ICD-10 Summit in Washington DC on April 12, 2011, Karen Trudel, the acting director of CMS’s Office of E-Health Standards and Services stated: “THE DEADLINES ARE NOT CHANGING”

  4. Who Needs to be Familiar with ICD-10-CM • Senior Management • Clinicians • IT Personnel • Data Security Personnel • Billing Personnel • Coding Personnel • Accounting Personnel

  5. Staff Education Costs • Will you outsource the education or conduct it internally? • If you have a coding expert on staff consider the time it would take for him/her to train your staff • What are the costs and benefits of these two options? • When will the education need to be done? • It is recommended to start the training your personnel six months prior to October 2013. • If you start too early, your staff will forget what they learned before having to apply their ICD-10 coding knowledge. • Who will need what level of education?

  6. Staff Education Costs • What options are available for education? • Web based training • Face to face workshops • Books • Audio seminars 6. How will the workload be managed while staff are receiving education?

  7. Comparing ICD-9-CM to ICD-10-CM ICD-9-CM ICD-10-CM More than 68,000 codes Consists of three to seven characters First digit is alpha All letters used except for U Second and third digits are numeric Fourth, fifth, sixth and seventh digits can be alpha or numeric Decimal placed after the first three characters • Approximately 13,000 codes • Consists of three to five characters. • First digit is numeric or Alpha (E or V) • Second, third, fourth and fifth digits are numeric. • Always at least three digits • Decimal placed after the first three characters

  8. Code Structure of ICD-10-CM versus ICD-9-CM ICD-9-CM Code Format ICD-10-CM X XX . X XXX category etiology, extension anatomic site manifestation X XX . XX category etiology anatomic site, manifestation

  9. New Features Found in ICD-10-CM • Laterality (left, right, bilateral) • Combination codes for certain conditions and common associated symptoms and manifestations • Combination codes for poisonings and their associated external cause • Obstetric codes identify trimester instead of episode of care

  10. New Features Found in ICD-10-CM • Character “x” is used as a 5th character placeholder in certain 6 character codes to allow for future expansion and to fill in other empty characters when a code that is less than 6 characters in length requires a 7th character, (example T15.02xD) • A number of codes have been significantly expanded (injuries, diabetes, substance abuse and postoperative complications) • Injuries are grouped by anatomical site rather than by type of injury

  11. New Features Found in ICD-10-CM • Certain diseases have been reclassified to different chapters or sections in order to reflect current medical knowledge • New code definitions (e.g., definition of acute myocardial infraction is now 4 weeks rather than 8 weeks) • V codes and E codes are incorporated into the main classification rather than separated into supplementary classifications as they were in ICD-9-CM

  12. Chapters in ICD-10-CM • Infections and Parasitic Diseases (A00-B99) • Neoplasms (C00-D49) • Diseases of the Blood and Blood Forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89) • Endocrine, Nutritional and Metabolic Diseases (F01-F99) • Mental and Behavioral Disorders (F01-F99) • Diseases of the Nervous Systems (G00-G99) • Diseases of the Eye and Adnexa (H00-H59 • Diseases of the Ear and Mastoid Process (H60-H95)

  13. Chapters in ICD-10-CM • Diseases of the Circulatory System (I00-I99) • Diseases of the Respiratory System (J00-J99) • Diseases of the Digestive System (K00-K94) • Diseases of the Skin and Subcutaneous Tissue (L00-L99) • Diseases of the Musculoskeletal and Connective Tissue (M00-M99) • Diseases of the Genitourinary System (N00-N99) • Pregnancy, Childbirth and the Puerperium (O00-O9A) • Certain Conditions Originating in the Perinatal Period (P00-P96

  14. Chapters in ICD-10-CM • Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99) • Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99) • Injury, Poisoning and Certain other Consequences of External Causes (S00-T88) • External Causes of Morbidity (V00-Y98) Classification of environmental events and circumstances as the case of injury and other adverse effects • Factors Influencing Health Status and Contact with Health Services (Z00-Z99)

  15. Recommended Web Sites • ICD-TEN e-newsletter http://www.ahima.org/images/newsletters/icdTen/subscribe.html • AHIMA ICD-10 http://www.ahima.org/icd10/default.aspx Quick Reference Information http://www.cms.gov/ICD10/Downloads/ICD-10QuickRefer.pdf CMS Provider Resources http://cms.gov/ICD10/05a_ProviderResources.asp#TopOfPage ICD-10 Data.com is free access to ICD-10 medical codes http://www.icd10data.com

  16. Recommended Books • ICD-10-CM and ICD-10-PCS Preview from AHIMA • Detailed Instruction for Appropriate ICD-10-CM Coding from Ingenix • 2011 Advanced Anatomy and Physiology for ICD-10-CM/PCS from Contexmedia

  17. QUESTIONS?????????

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