ICD-10 Codes: A Blessing in Disguise

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ICD-10 Codes: A Blessing in Disguise

TL;DR
ICD-10’s sometimes overwhelming selection of code to choose from can be daunting. The vast number specificity of the codes available will improve the care a diagnosis of patients in the healthcare industry immensely.

ICD-10’s 68,000 Codes

ICD-10 contains more than five times as many diagnostic codes as ICD-9, boasting 68,000 codes against ICD-9’s mere collection of 13,000. Just looking at that number, it’s easy to see how it may appear intimidating to anyone at first, but there’s really not much to be afraid of here.

The codes are notorious for being overly specific (such as Y92.146: swimming pool of prison as the place of occurrence of the external cause; or Z63.1: problem in relationship with in-laws – yes, there’s a code for that!). Don’t believe it? Check out our infographic on which animals you might want to stay away from.

In all seriousness though, this specificity is what will transform and, eventually, simplify our diagnostic system. As outrageous as some of them may seem, they are designed so that conditions can be easily identified and quickly reported. For example, ICD-10 classifies on which side an afflicted body part is located, right or left, and provides a separate code for each side.

Suppose you had a patient come in with an open fracture of the right arm. ICD-9 has two possible codes for you:

  • A closed arm fracture (818.0)
  • An open arm fracture (818.1)

And that’s as far as it goes. There is no option to go into greater detail for right or left.

Now, take a look at the ICD-10 codes:

  • A general closed arm fracture (S42.309A)
    • Right arm (S42.301A)
    • Left arm (S42.302A)
  • A general open arm fracture (S42.309B)
    • Right arm (S42.301B)
    • Left arm (S42.302B)

Here’s an example of some of those codes in the PrognoCIS EHR workflow, which allows you to quickly search for the code you want, while also showing you the ICD-9 equivalent to make the adjustment easier.

PrognoCIS ICD-10 Workflow

For a fracture of the right arm, there are six different codes to choose from. You can go into as much detail as you feel is necessary, because with ICD-10, you will have the option to do so. Roadto10.org, a website developed by CMS to prepare for the change, says that the right vs. left codes account for more than 40% of the 68,000. A little less intimidated now? Once you understand the system, you’ll be able go on with life as usual – it just might be a little more specific.

Progress is the cornerstone of our society. It is the key factor in moving us forward and motivating us to strive to our full potential.

As of today, we are only 96 days away from the upcoming ICD-10 deadline, and it seems as though the new coding system will finally go live without further delays. Starting October 1st, 2015, all HIPAA-covered entities (defined as health plans, healthcare clearinghouses, and healthcare providers) must be ICD-10 compliant. However, there is still some opposition from the government and reluctance from providers about implementing the new codes. This hesitation stems primarily from a place of uncertainty. Many are unsure as to what exactly ICD-10 will bring and how to adjust to it.

ICD-9 has been in place since 1979, and, for the past 36 years, physicians have used it diligently. However, this also means that it has been 36 years since the codes have been revised. When we consider how much scientific and medical progress we’ve made in that time, it seems almost silly to keep using this outdated method of documentation. So much has changed in how we diagnose and treat patients, and it’s necessary to reflect that change within our coding system. For a nation whose foundation is so entrenched in progress and an eagerness to embrace new technology, we have become somewhat sloth-like in moving to accept this particular development. According to the Centers for Medicare and Medicaid Services (CMS), “the United States is the last major industrialized nation to make the switch to ICD-10.”

So, as a friend once said, if you’re going to be late to a party, show up looking good. We’re proud of the ease-of-use features we’ve added to PrognoCIS for ICD-10, and we’ll help you look good as you make the transition.

How do you feel about ICD-10? Will the new codes make a positive difference in healthcare?

Author: Apoorva Anupindi

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