The Transition Of ICD-9 to ICD-10

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ICD-9 to ICD-10 Transition

ICD-10 has significantly more codes, structural and conceptual differences over ICD-9 but not every healthcare professional has to deal with the full ICD-10 code set though health care providers, payers, clearinghouses, and billing services must comply with the transition to ICD-10. ICD-10 will affect diagnosis and inpatient procedure coding for those submitting medicare or medicaid claims and those who are covered by the Health Insurance Portability and Accountability Act (HIPAA) including doctors, hospitals and health insurance companies who use codes for diagnosing and billing. The transition does not affect the American Medical Association's CPT (Current Procedural Terminology) codes used for outpatient procedures.

It is imperative to understand the differences for a smooth transition from ICD-9 to ICD-10. Expanded Details for many conditions like viral hepatitis in ICD-10-CM are a basic change out of many changes. From 14000 diagnosis codes to over 68000 codes, procedure codes from 4000 to 87000, the transition reflects a near five-fold increase in diagnosis codes. ICD-10 codes include more details and terminologiesthereby providing benefits because of the increased level of details.

ICD-9-CM (Clinical Modification) has an alphabetic index and a tabular index and is used to report diagnoses. ICD-9-CM codes have 3 to 5 characters that are numeric except for the V codes (influencing healthcare), E codes (external causes of injury) and M codes (neoplasm morphology). ICD-10-CM codes have 3 to 7 characters that are alphanumeric.

ICD-9-CM code structure

ICD-9-CM has an alphabetic or numeric first digit; the remaining digits are numeric. Minimum of three digits, maximum of five digits; decimal after 1st three digits    Eg: X XX . X X

ICD-10-CM code structure

ICD-10-CM starts with alpha (uses all letters except "U"); 2nd character always numeric; 3rd-7th characters can be alpha or numeric; decimal is always after 1st three digits    Eg: X XX . X XXX

ICD-9-CM vs ICD-10-CM diagnosis codes comparison

ICD-9 ICD-10
13000 codes Over 68000 codes
3 to 5 characters 3 to 7 characters
First character may be alpha or numeric, characters 2-5 are numeric Character 1 is alpha; Characters 2 and 3 are numeric; characters 4-7 are alpha or numeric
17 chapters 21 chapters
Separate V and E codes Supplemental Classification incorporated into main classification
Limited space for new codes Flexibility to add new codes
Lesser details Greater details

ICD-9 vs. ICD-10 Procedure codes comparison

ICD-9 ICD-10
3-4 numbers 7 alpha-numeric characters
Approx 3,000 codes Approx 87,000 available codes
Uses outdated technology Updated medical terminology and devices
Lesser details and description Greater details and description of methodology
Limited space for adding new codes Flexibility to add more codes

Learning new ICD-10 codes and implementing without fully understanding the codes may result in claim denials for the providers. Cloud based EHR help guide users to automate transition to ICD-10. 75Health supports this transition with tools with EHR workflows with ease and simplicity.