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Lecture 2-1.pdf

The lecture discusses the transition from ICD-9 to ICD-10, highlighting the limitations of ICD-9, such as outdated codes and lack of specificity. ICD-10 offers numerous benefits, including greater detail, expanded code options, and improved clinical relevance, which enhance healthcare delivery and monitoring. Key differences include the increase in codes from 13,600 to 69,000 and the introduction of new features like combination codes and episode of care extensions.

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rawabi.4004
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7 views

Lecture 2-1.pdf

The lecture discusses the transition from ICD-9 to ICD-10, highlighting the limitations of ICD-9, such as outdated codes and lack of specificity. ICD-10 offers numerous benefits, including greater detail, expanded code options, and improved clinical relevance, which enhance healthcare delivery and monitoring. Key differences include the increase in codes from 13,600 to 69,000 and the introduction of new features like combination codes and episode of care extensions.

Uploaded by

rawabi.4004
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Lecture 2

Conversion from ICD 9 to ICD


10
Learning
Objectives
At the end of this lecture you will be able to explain;
• Problem with the current ICD-9 coding system

• Benefits fro implementing ICD 10th version


• Significant improvements in ICD 10threvision

• Major changes from ICD 9 to ICD 10th version


Why is ICD-9 Being
Replaced?
1) ICD-9-CM is out of date and running out of space for new codes.
Lacks specificity and detail •
No longer reflects current medical practice •
2) Conversion to ICD-10 is necessary to fully realize benefits of HIT
Adoption.
3) ICD-9-CM diagnosis codes do not provide sufficient clinical specificity
4) ICD-9-CM system is ineffective for effectively monitoring utilization

of resources
Benefits of Implementing ICD-10-
CM
1. ICD-10-CM incorporates greater specificity, clinical data,
and information relevant to ambulatory and managed care
Encounters .
2. The structure of ICD-10-CM allows for the possibility of
greater expansion of code numbers .
3. Risk factors of disease and injuries are included that are

frequently encountered in a primary care setting .


4. The new system also includes those diseases discovered
since the most recent revision of ICD-9-CM
Benefits of Implementing ICD-10-
CM
5. General terminology, as well as disease classification,
has been updated to be consistent with accepted and
current clinical practice .
6. expanded degree of specificity provide more detailed informa
which would assist providers, payers, and policy makers in
-establishing appropriate reimbursement rates -improving the delive
healthcare
-improving and evaluating the overall quality of patient care -effectiv
monitoring both service and resource utilization
Major Differences Between ICD-9-CM and ICD-10-
CM

ICD – 9-CM ICD – 10-CM


13,600 codes 69,000 codes
Code book contains 17 chapters Code book contains 21 chapters
Consists of 3 to 5 characters Consists of 3 to 7 characters
1st character is alpha or numeric 1st character is alpha
Only utilizes letters E and V Utilizes all letters (except U)
Second, third, fourth, and fifth Second character is always
characters are always numeric numeric
Third, fourth, fifth, sixth, and seventh
characters can be alpha or numeric
Shorter code descriptions because of lack Longer code descriptions because of greater
of specificity and abbreviated code clinical detail and specificity
titles and full code titles
Comparison of ICD-9-
CM and ICD-10-CM ICD-10-CM
CODE
ICD-9-CM CODE A - Category of code •
B - Etiology, anatomical site, •
• A - Category of code and/or severity
• B - Etiology, C - Extension •
anatomical site, and 7th character for obstetrics, •
injuries, and external causes of
manifestation injury
ICD-9-CM Structure –
Format

Numeric or Alpha
(E or V) Numeric

4
V
X
E
5 1
X X4 . 0
X 0
X

Category
Etiology, Anatomic Site,
Manifestation

Characters 5 – 3
ICD-10-CM Structure –
Format

Alpha Numeric or Alpha 7 - 2 Additional


(Except U) Characters

M
A
XS X3 X2 . X0 X1 X0 A
X
Added code extensions (7th
Category Etiology, Anatomic Site, character) for obstetrics,
injuries, and external
Severity causes of injury

Characters 7 – 3
New Features of ICD-10-
CM
1. Combination codes for conditions and common symptoms
or manifestations
2. Combination codes for poisonings and external causes
3. Expanded codes: injury, diabetes, alcohol/substance
abuse, postoperative complications
4. Alphanumeric seven characters (digits and letters) codes
and include all letters except "U," thus providing
a greater pool of code numbers
5. V and E codes are incorporated into the main
classification
New Features of ICD-10-
CM
6. Added extensions for episode of care
7. Inclusion of trimester in obstetrics codes and
elimination of fifth digits for episode of care
8. Expanded detail relevant to ambulatory and managed
care encounters
9. Inclusion of clinical concepts that do not exist in ICD-
9-CM
References
http://library.ahima.org/doc? •
oid=59978#.WFGXZdJ97IU
http://apps.who.int/classifications/apps/icd/ •
/Training
https://www.aapc.com/medical-coding-books/ •
icd-9-book.aspx
ICD 9 CM official Reference book CPT 2015 •
official book •

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