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What are the practical differences between ICD-9-CM and ICD-10? - Does anyone know?

Posted: Oct 25, 2011

I've been reading a little bit about it, but what are the actual differences between ICD-9 and ICD-10? Does anyone know?

I'm not sure, but Redpen or one of the other experienced coders will know - nm

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nm

I think what we've learned is, we don't know anything about it - Just sayin

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You would think someone would know a little more about this, because it's a big thing and it is happening soon. Not one of us seems to know anything about it, really.

It's more specific. I think it has an extra digit. - All I know which is not much

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I have heard that hospitals are having to put in new equipment because ICD-10 requires an extra digit, because it's more specific. I'm sure there's more to it than that, but that's as much help as I can give on the subject.

Not sure, but is it supposed to be faster and easier? - Lou

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I can see why they would want to make it faster and easier. Maybe that's the point of all of it.

Isn't it supposed to take effect in 2014? - Terrified of learning ICD-10

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The whole thing sounds scary to me. The teachers are just clueless when you ask them questions about it. They don't have any answers.

The scary thing about is nobody knows very much - In my opinion

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Anything new is always scary, but in this case, most of us are clueless. That is really scary!

I believe it's 2013 - nm

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nm

I don't know why they don't leave it as it is - If it aint broke dont fix it

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What's wrong with the version we have right now? Why do they have to change it?

ICD-10 - formerMT

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The version we have right now, is not sufficient to code to the detail of treatment, the rest of the world has been on ICD-10 for awhile, we are just getting it. It will be effective February 2013, right around the corner. They are changing it to get on board with the rest of the world, to increase efficiency, to provide a greater level of detail and improve the reimbursement cycle.

ICD-10 - sm

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A lot of coders know ICD-10, but you might not have met any of them. The people who are most focused on learning it right now are faculty and coders closely involved with the transition process.

The US will switch to ICD-10 in October of 2013. The move is necessary because we outgrew ICD-9. There weren't enough code numbers left to enable us to add new diseases. Medical knowledge has exploded in the last few decades, tons of procedures using equipment unheard of years ago are now possible, and there is an increased need to collect accurate, specific information about patients for research purposes and for reimbursement.

ICD-10 will allow us to classify diseases and conditions more specifically since the codes have more digits. It has room for more codes and room for expansion.

There are 2 parts to ICD-10. If you are an outpatient coder, you only need the diagnoses. Inpatient coders will also need to learn the procedure code set.

The diagnosis codes are very much like what you have now. There are more digits and the numbering is a little different, with codes beginning with a letter, but it's basically the same. The organization of the code set is basically the same. You will still look up codes in the Alphabetic Index and then in the Tabular List. There are just more possible diagnoses and more detail in the codes.

The procedure codes are quite different. Outpatient will still use CPT codes, but inpatient coders will use ICD-10-PCS. Since it is a completely different animal, it will take longer for you to learn. You might need more background knowledge of medicine, procedures, and anatomy. The main difference is that you construct the code as you code rather than relying on the same static, kind of vague codes in the code set now. Each digit in the code codes some feature of the procedure -- the type of procedure, the location, the approach, instruments used, etc. Again, it isn't terribly difficult.

Is it faster? Not particularly, but that isn't the reason for the change. The reason is that the current code system WAS broken. ICD-10-CM/PCS will fix that. It will give us a code set that can be used for years to come.

I sure hope - sm

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coding gets more accurate. My husband injured his finger and the bill had 2 surgeries on it, one was for putting stitches in and the other was for putting a gauze wrap on it. When I asked why there was a 390 dollar charge for putting gauze on and it was called a surgery, they told me that was just how it is coded. That's ridiculous.

Thoughts - sm

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Where was this done? Did the bill state the CPT code numbers for these "surgeries"? They would be 6-digit numbers.

There would have been a code for the repair itself, which would include local anesthesia, stitching, and bandaging. There could also have been a code for the supplies used--the anesthetic, the syringe, the suture material, the scissors, the drape, the Betadine, the swabs, and the bandage. That is a surgical tray, which has a code, but the words they use sometimes don't convey what it is. $390 wouldn't be unreasonable for that, especially if this occurred in an ER.

Does that look like what you have on the bill?

Unless you saw other charges for supplies, my guess is that the $390 is for the tray. It should not be for applying a bandage, though, because that is included in the repair code.

Keep in mind, too, that ER bills can include all sorts of things other than the repair--they can charge for the facility while you can still get a bill from the doctor. Some of their charges can be outrageous, which is why you want to avoid using an ER whenever possible.

This is Excellent Information - Beautifully Written and Easy To Understand - Thank You!

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Finally we have a clear and informative explanation about the why's and wherefore's of ICD-10. I thought I knew quite a bit about it until I read this and realized that I not only could I not have described it this well, I actually learned something! Thank you, again.

You're welcome - glad it helped - sm

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Thanks, I'm glad you liked it. I appreciate the comment that it was clear and informative, and that I had described it well. After being called rude and sarcastic elsewhere on this board, I almost didn't answer.

I thought it sounded like Redpen because you write beautifully and well - Thank you again

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I always learn something from what you write. Please don't stop posting. You have a lot to offer.

ICD-10 - formerMT

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I am taking ICD-10 right now, the main differences are:
7 digit codes as opposed to 5
Laterality markers (R and L) sides with a terminal digit.
more OB-GYN codes
there is an ICD-10 CM an ICD-10 procedure manual, this will take the place of the CPT.
it is very, very, very detailed and I am literally reading every word of it over and over and over!

Correction - it isn't taking the place of CPT - sm

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ICD-10-PCS is not taking the place of CPT. It is only replacing the ICD-9 procedure codes.

CPT is used for physician services (outpatient coding). It will continue to be used for that. In most cases, outpatient coders will not need to learn ICD-10-PCS.

If you are just learning this, then it's understandable that you would feel it necessary to read it over and over. That's just because it is new to you. It would be especially noticeable if you were not already a coder. All new coders feel that the code set is very, very, very detailed, but they get over this eventually and settle down to seeing it as just a code set.

None of the differences you mention in ICD-10-CM will make a hill of beans difference in how coding is done. The process is exactly the same -- the code numbers may differ in structure and there may be more codes available, but using the code set is the same.

ICD-10-PCS, on the other hand, is different and many coders will have to expand their knowledge of medicine considerably in order to use it.

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