Differences between ICD-9 and ICD-10 Medical Billing and Coding Systems - dummies

Differences between ICD-9 and ICD-10 Medical Billing and Coding Systems

As a medical billing professional, it is essential that you understand the differences between ICD-9 and ICD-10. Repeat after me: ICD-9 is to ICD-10 as VCR is to DVR. In other words, ICD-9 is the old school coding classification system, while ICD-10 is the new kid in town.

The differences between the two are fairly significant. Here are a couple of areas where they differ:

  • Number of codes: ICD-9 has just over 14,000 diagnosis codes and almost 4,000 procedural codes. In contrast, ICD-10 contains over 68,000 diagnosis codes (clinical modification codes) and over 72,000 procedural codes.

  • The info conveyed by the code: ICD-9 codes contain three to five digits beginning with either a number or a letter, with a decimal point placed after the third digit, and the ICD-9 book indicates the level of specificity for each code. ICD-10 codes, on the other hand, are seven digits in length.

    The first three digits are similar to the corresponding ICD-9 code, with a decimal point after the third digit. But the digits that follow the decimal point have specific meaning. For medical and surgical procedures, for example, the digits that follow are specific to body part, surgical approach, and other qualifiers needed for billing. Similarly, the ICD-10 CM codes that represent diagnosis codes also have seven digits.

    The first three are similar to the ICD-9 code, but the additional codes add specificity to the code such as laterality, chronic versus acute, and so on.

The latest revision of ICD, ICD-10, has been in effect since 1998, but you wouldn’t know that here in the U.S., which is the last industrialized nation to implement ICD-10 has managed to stage a 10-year delay. Opposition to ICD-10 is primarily based on the timing of initial costs, particularly at a time when the U.S. is trying to control the rising cost of healthcare.

Today, despite pushback from medical organizations like the American Medical Association (AMA), the United States is planning to go forward with ICD-10 implementation.

The move to ICD-10 involves more training for you because ICD-10 codes are all seven-character long alphanumeric codes. If a specific “place” in the code isn’t to be used, a placeholder character (x) replaces it. This represents an entirely different way of coding and will challenge even the most seasoned professionals in the early stages.