What is ICD-10-CM and ICD-10-PCS? ICD-10-CM is the new US clinical modification standard of the International Classification of Disease ICD-10. It will replace the current ICD-9-CM by October 1, 2013. ICD-10-CM is maintained by NCHS (National Center for Health Statistics). It includes the level of detail needed for disease classification and diagnostic specification in the United States. It consists of more than 68,000 diagnosis codes while ICD-9-CM has a little more than 13,000 diagnosis codes.
ICD-10-PCS is the new US procedural coding system developed under the direction of CMS ( Medicare & Medicaid Services). It is more detailed than the short volume of procedure codes in ICD-9-CM. It consists of 87,000 procedure codes while ICD-9 CPT has 17,000 codes. It will too replace the current ICD-9-CM procedure coding by January 1, 2012 for inpatient procedures.
What are the differences between ICD-10-CM and ICD-9-CM?
ICD-9-CM: 3-5 characters; first character is numeric or alpha; characters 2-5 are numeric; always at least 3 characters; use of decimal after 3 characters; lacks sufficient capacity; no longer reflect current knowledge of disease and latest medical terminologies.
– ICD-10-CM: 3-7 characters; first character is alpha; characters 2-7 are alpha or numeric; always at least 3 characters; use of decimal after 3 characters; has the capacity for new diseases like SARS and WNV; it will have the capacity to include current and future knowledge of disease and medical terminologies; offers greatest coding accuracy and specificity; ICD-10 codes are broken down into chapters and sub chapters, disease are grouped be letters.
Will ICD-10-CM and ICD-10-PCS affect physician Office billing?
Providers in all healthcare settings will use ICD-10-CM diagnosis codes for reporting, payment, and other purposes. ICD-10-PCS wil be used only for inpatients billing by hospitals. Physicians will continue to use Current Procedural Terminology (CPT-4) and Healthcare Common Procedure Coding System (HCPC) to bill for their services.
Does ICD-10 lend itself to the use of Electronic Medical Record?
Yes, ICD-10-CM and PCS are better suited for use in EMRs because they permit a better mapping from SNOMED-CT the clinical reference terminology and more suited to computer-assisted coding.
How long would it take coders and healthcare providers to learn the ICD-10?
Various studies have suggested that coders and healthcare providers will have a level of proficiency within 6 months of using the new coding system.
Are mapping available between ICD-9-CM and ICD-10-CM?
Yes, for a more detailed mapping visit http://www.cdc.gov/nchs/about/otheract/icd9/icd10cm.htm.
Where can I find more information about ICD-10-CM and ICD-10-PCS?
o For ICD-10-CM visit NCHS website at “http://www.cdc.gov/nchs/about/otheract/icd9/icd10cm.htm.
o ICD-10-PCS information can be found on the CMS website.
o For more ICD-10 resources visit AHIMA Web site.
Where can I find information about estimated costs to my practice for transitioning to ICD-10-CM? A study done by Nachimson Advisors titled “The Impact of Implementing ICD-10 on Physician Practices and Clinical Laboratories” has detailed cost estimates of transitioning to the new coding system.
Marwan Madanat is in charge of Alphamed Solutions, Inc. operations and business development. Alphamed Solutions is a national healthcare company focusing on delivering innovative and quality medical services and technology solutions to physicians and medical practices nationwide. Our clients include practices in single to multiple specialties and of different sizes. Alphamed solutions and services include EMR/PM consulting, Revenue Cycle Management, medical billing and medical transcription. Our services empower practices of all sizes to maximize their clinical, financial and operational efficiencies and ultimately improve patient quality of care and physicians quality of life.