PRACTICEFIRST CODING CORNER… AUGUST 2013

By Lisa Kropp

As we prepare for ICD-10-CM, Practicefirst will begin to provide tips & tools to help your practice transition to ICD10!

Benefits to ICD-10-CM

The new, up-to-date classification system will provide much better data needed to:•

  • Measure the quality, safety, and efficacy of care
  • Reduce the need for attachments to explain the patient’s condition
  • Design payment systems and process claims for reimbursement
  • Conduct research, epidemiological studies, and clinical trials
  • Set health policy
  • Support operational and strategic planning
  • Design health care delivery systems
  • Monitor resource utilization
  • Improve clinical, financial, and administrative performance
  • Prevent and detect health care fraud and abuse
  • Track public health and risks

Structure of ICD-10-CM

  • 3–7 digits;
  • Digit 1 is alpha; Digit 2 is numeric;
  • Digits 3–7 are alpha or numeric (alpha characters are not case sensitive); and
  • Decimal is used after third character.

Examples:

  1. A78 – Q fever;
  2. A69.21 – Meningitis due to Lyme disease; and
  3. S52.131A – Displaced fracture of neck of right radius, initial encounter for closed fracture.

Some New Features Found in ICD-10-CM

  1. Laterality (left, right, bilateral).
    1. Example:  C50.511 – Malignant neoplasm of lower-outer quadrant of right female breast
  2. Combination  Codes for certain conditions and common associated      symptoms and manifestations.
    1. Example: I25.110 – Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
  3. Combination  codes for poisonings and their associated external cause
    1. Example: T42.3x2S – Poisoning by barbiturates, intentional self-harm, sequel
  4. Obstetric codes identify trimester instead of episode of care
    1. Example: O26.02 – Excessive weight gain in pregnancy, second trimester
  5. Inclusion of clinical concepts that do not exist in ICD-9-CM (e.g., underdosing, blood type, blood alcohol level)
    1. Example: T45.526D – Underdosing of antithrombotic drugs, subsequent encounter
  6. Significantly expanded codes (e.g., injuries, diabetes, substance abuse, postoperative complications)
    1. Example: E10.610 – Type 1 diabetes mellitus with diabetic neuropathic arthropathy
    2. Example: F10.182 – Alcohol abuse with alcohol-induced sleep disorder
    3. Example: T82.02xA –  Displacement of heart valve prosthesis, initial encounter
  7. Codes for postoperative complications have been expanded and a distinction made between intraoperative complications and postprocedural disorders
    1. Example: D78.01 –  Intraoperative hemorrhage and hematoma of spleen complicating a procedure on the spleen
    2. Example: D78.21 – Postprocedural hemorrhage and hematoma of spleen following a procedure on the spleen.

 With 15 months until implementation, how are you preparing for ICD10? 

Contact Lisa at 716.348.3904 or lisak@pracfirst.com for more information on how our coding service can partner with your practice!

 

&nbs

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