ICD-10 Transition: Challenges and Opportunities for the 21 st Century
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1 ICD-10 Transition: Challenges and Opportunities for the 21 st Century May 2015 The Montana Hospital Discharge Data System
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3 International Classification of Diseases (ICD) Statistical classification of diseases and health problems
4 International Classification of Diseases (ICD) Codes Medical Billing (Clinical Modification) Morbidity Mortality
5 International Classification of Diseases (ICD) Ms. B has Type 1 diabetes without complications ICD-9: 250.1; DM without mention of complication, Type I, not stated as uncontrolled ICD-10: E10.9; Type 1 DM without complications
6 International Classification of Diseases (ICD) ICD-10-AM (Australia) ICD-10-CA (Canada) ICD-10-GM (Germany). ICD-10-CM (USA)
7 International Classification of Diseases (ICD) ICD-10-CM must conform to WHO conventions Changes at fifth, sixth, and seventh digits
8 Structure of ICD-10
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10 Versions ICD-9: Ratified in 1975, still in use in United States for morbidity ICD-10: Ratified in the early 1990s, in use in mortality since 1999.
11 Versions ICD England 1999 Australia / US mortality 2000 Canada
12 Versions ICD-9-CM to ICD-10-CM Oct 1, 2015 US transition date
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14 ICD-10 Transition Date
15 ICD-10 Transition Date Medical Coders AHIMA, AMBA Hospitals AHA Insurers BCBS Association, Anthem
16 ICD-10 Transition Date The vast majority of hospitals expect to be ready to transition to ICD-10 by Oct 1, There should be no further delay in moving. AHA July 2013
17 ICD-10 Transition Date
18 ICD-10 Transition Date For more than a decade, the AMA kept ICD-10 at bay and we want to freeze it in carbonite! Robert M. Wah, President of the AMA, Nov 2014
19 ICD-10 Transition Date Oct 1, 2013: Jan 15, 2009 Oct 1, 2014: April 1, 2014 Oct 1, 2015:?
20 ICD-10 Transition Date Political History Affordable Care Act (2010) Protecting Access to Medicaid Act (2014)
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22 ICD-10 Depth ICD 9: 15,000 codes ICD 10: 70,000 codes
23 Included among these codes will be 312 new codes for injuries from animals; 72 new codes for injuries just from birds; 9 new codes for injuries from the macaw. Rand Paul ICD-10 Depth
24 ICD-10 Depth
25 ICD-10 Depth Basic structure Digits 1-3 will now refer to the category Digits 4-6 will cover clinical details such as severity, etiology, and anatomic site (among others), and are either alphabetic or numeric Digit 7 will serve as an extension when necessary, and will be either alphabetic or numeric
26 ICD-10 Depth
27 ICD-10 Depth Ms. Jones is a 22-year-old university student that sustained a fall on left outstretched hand. She presented to clinic with obvious deformity and history, physical exam, and imaging consistent with left distal radius fracture (extra and intracular).
28 ICD-10 Depth Closed fracture of lower end of forearm, unspecified (813.40) Fall (E888.9)
29 ICD-10 Depth Fracture, radius, lower end, extraarticular, left, initial encounter for closed fracture. (S52.552A) intrarticular (S52.572A) Fall, unspecified, initial encounter (W19.XXXA)
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31 ICD-10 Changes Codes for new diseases Ebola ICD-9-CM: (Other specified arthropod-borne hemorrhagic fever) ICD-10-CM: A98.4 (Ebola virus disease)
32 ICD-10 Changes Laterality S40.211: Abrasion of right shoulder S40.212: Abrasion of left shoulder
33 ICD-10 Changes Phase of treatment S40.211A: Abrasion of right shoulder (Initial encounter) S40.211D: Abrasion of right shoulder (Subsequent encounter)
34 ICD-10 Changes Combination codes Mild nonproliferative diabetic retinopathy due to uncontrolled Type II diabetes
35 ICD-10 Changes Combination codes ICD-9-CM: (Diabetes with opthamalic manifestations, Type II, not stated as uncontrolled); (Mild nonproliferative diabetic retinopathy) ICD-10-CM: E (Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema)
36 ICD-10 Changes External Cause Place of Occurrence ICD-9: 10 Codes ICD-10: Hundreds of codes
37 ICD-10 Changes Ms. Jones is a 22-year-old university student that sustained a fall on left outstretched hand while assisting a patient in the bathroom of the nursing home where she works.
38 ICD-10 Changes ICD-9-CM: E849.7 (Residential institution) ICD-10-CM: Y92.12 (Bathroom in nursing home)
39
40 Mortality ICD-10 Impact
41 ICD-10 Impact Minimal initial impact on hospital payments 98.93% of Diagnosis Related Groups (MS-DRGs) the same -.04% change in payments Additional detail simplifies billing
42 ICD-10 Impact Difference Mortality vs Morbidity Primary diagnosis MS-DRG 88 Concussion w MCC 89 Concussion w CC 90 Concussion w/o CC/MCC Underlying cause
43 ICD-10 Impact Medical record Documentation
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