If you have been on the blogs, YouTube or Googling ICD-10 you are bound to find someone poking fun at ICD-10 readiness. It’s all fun and games until you actually have to switch to the new code set this October. At the same time, you have to admit a little light heartedness in your ICD-10 Readiness planning doesn’t hurt. The ICD-10 Code V91.07xA (Water ski on fire) wasn’t just made up – see the video for yourself!

Fun aside, ICD-10 has already been postponed multiple times and clinics shouldn’t expect it will be delayed again. Getting a plan in place to address the issues your clinic will face come October 1st can’t be delayed either. Putting ICD-10 changes into perspective and having a realistic idea of what the issues will be is a good place to start.

Let’s start with the overall increase in ICD-9 to ICD-10 codes from 18,445 to 141,752. First, physicians don’t use the procedure portion of ICD-10. Physicians will continue to use Current Procedural Terminology (CPT) to report both inpatient and outpatient procedures. The procedure portion of ICD-10 is only used by hospitals for reporting inpatient procedures. This brings the number down to 69,832 diagnosis codes versus only 14,567 ICD-9 codes. Cut it in half already!

Now, you can almost cut this number in half again for the specifications for left and right side of the body included in ICD-10. More specifically, the number of codes for left and right distinctions are 46%, or 25,626 codes.

Another major reason for the increase in ICD-10 diagnosis codes is for injury and poisoning. In fact, there are 39,869 injury and poisoning codes in ICD-10. This is in comparison to only 2,587 in ICD-9.

Use of ICD-10 is very dependent on the codes that are relevant to your doctors clinical specialty. Narrow the code set down again by what will you actually have to use in day-to-day medical practice at your clinic.

The ICD-9 reality is such that there is too often limited identification of the problem with the patient and what treatment was actually done. With ICD-10 you have greater access to detail in the coding with descriptions for illness, injuries, and treatment which increases needed specificity.

With so many specific codes you can quickly and correctly identify which one to use by implementing coding workflow tools for internal coding staff. These tools vary in price and features but are generally accessible to any office at around $1000 a year. Most have robust code search features that allow you to quickly identify the correct ICD-10 code. Some are web based while others are designed to integrate directly with practice management and electronic medical records systems. With an electronic tool, searching for 100 or 10,000 is really not much different.

At the end of the day though you are still wondering why we have felt the need to create a code for water ski’s on fire. Fortunately, Medicare does not require doctors to report external cause of injury codes except in a few cases, for example surgery on wrong body part.

While you may never use this code in your office, increased specificity is one of the main advantages of ICD-10: there is a code for almost anything you can imagine. Rather than applying unspecified codes this removes a level of judgment and increases specificity which should help claims get paid faster. The need for medical records could actually decrease because the code provides so much more detail than ICD-9. Faster claim processing means better cash flow for clinics.

Change is difficult, but it ultimately will be for the better. If you haven’t started preparing already then get moving today. Taking our on-line assessment at www.ICD-10StressTest.com is one way to take the first step.

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