Medical Coding: Switching from ICD-9 to ICD-10 - dummies

Medical Coding: Switching from ICD-9 to ICD-10

By Karen Smiley

Part of Medical Billing & Coding For Dummies Cheat Sheet

The International Classification of Diseases (ICD) is a list of medical classifications used in medical coding. ICD-9 has been used in the United States since 1979, but ICD-10 is coming, ready or not. ICD-10 will result in more specific data, which in turn will assist the World Health Organization (WHO) in its efforts to identify viral mutations and other health threats. Currently, healthcare providers worldwide are obligated to be ICD-10 ready by October 2014. This gargantuan task is being implemented in phases:

  • Phase 1: Develop an implementation plan and identify potential impact on various office operations

  • Phase 2: Implement preparation, working with software vendors and clearinghouses to ensure compatibility

  • Phase 3: Go live with the 5010 platform in preparation for ICD-10 file transfer

  • Phase 4: Address and correct deficiencies identified in Phase 3

Educators and companies that publish coding materials have been working for several years to prepare coders for the transition. The AAPC and AHIMA, the two main credentialing organizations for billers and coders, have sponsored and will continue to sponsor workshops to assist coders in this process. Be sure to check these workshops out. Both organizations will also implement an ICD-10 certification testing process.

Following are some steps you (or your office) can take to prepare for the big switch:

  1. Prepare a report that lists, in order of frequency, currently used ICD-9 codes; then find the ICD-10 codes slated to replace them.

    Several online tools, or cross coding translators, map ICD-9 codes to ICD-10 codes. (The AAPC has an ICD-10 code translator and so does Medicare.) This task can help you identifying the ICD-10 codes that your provider will use the most.

  2. After you identify the ICD-10 codes that will soon be part of the daily routine, make the practitioner aware of the specific documentation that is missing from current patient records.

    If your office will continue to use super-bills, this process helps identify which codes should be listed on the form.

  3. Work with the billing software vendor to make sure that the ICD-10 codes that are likely to be used immediately upon transition are programmed into the software.

    If not, you can make them aware of the codes your billing software will need to accommodate. Doing so ahead of time will help you minimize delays during the early days (or weeks or months) of the actual transition to ICD-10.