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.


  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 for more information on how our coding service can partner with your practice!



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