What is the difference between icd 9 cm and icd 10 cm codes

Historically, ICDCM was developed as a classification system for statistical compilation of data in inpatient settings. Unfortunately, it has proven to be inadequate for use in other healthcare settings and even for reimbursement purposes.

Even non-PPS payment methodologies require complete, accurate, and detailed coding in order to calculate appropriate reimbursement rates, determine coverage, and establish medical necessity.

Keeping all of the above uses in mind, it becomes quite clear that a classification system that provides greater coding accuracy and specificity is greatly needed. The purpose of the revision was to expand the content, purpose, and scope of the system and to include ambulatory care services, increase clinical detail, capture risk factors in primary care, include emergent diseases, and group diagnoses for epidemiological purposes.

It provides better information for nonacute care or nonhospital encounters, clinical decisionmaking, and outcomes research. Terminology and disease classification have been updated to be consistent with current usage and medical advances. This final rule designated five medical code sets to be used for assigning diagnoses and procedures. These are:. This final rule was effective on October 16, Most entities had to be in compliance by October 16, , although some smaller entities had until October 16, , to be compliant.

Various organizations have recommended that the Department of Health and Human Services should issue a proposed rule requiring that facilities adopt the new ICDCM codes as the national standard code set. Generally, ICDCM incorporates greater specificity, clinical data, and information relevant to ambulatory and managed care encounters. In addition, the structure of ICDCM allows for the possibility of greater expansion of code numbers.

This classification will also extend beyond simply the classification of disease and injuries to include risk factors that are frequently encountered in a primary care setting.

General terminology, as well as disease classification, has been updated to be consistent with accepted and current clinical practice. The expanded degree of specificity should provide more detailed information, which would assist providers, payers, and policy makers in establishing appropriate reimbursement rates, improving the delivery of healthcare, improving and evaluating the overall quality of patient care, and effectively monitoring both service and resource utilization.

These changes should result in major improvements in both the quality and uses of data for various healthcare settings.

ICD has been in use in other countries for several years. AHIMA surveyed several other countries regarding their implementation strategies and obstacles that they encountered.

AHIMA discovered that many other countries are disgruntled regarding the failure of the US to adopt the revision of ICD, again noting the inability to accurately compare data Worldwide. As mentioned previously, both Australia and Canada have developed modifications of ICD for use in their respective countries. ICDAM has been fully implemented in Australia since approximately , and most of Canada has completed the conversion.

Australia conducted two-day training workshops for experienced coding professionals, while Canada provided coding education in a three-phase plan. The first phase consisted of a self-learning package that required about 21 hours to complete. The second phase consisted of a two-day workshop, with a hands-on program.

In the third phase, a self-learning package of 10 case studies was provided to the coders. All of the education in Canada involved the use of coding software and not codebooks.

Both countries offer periodic refresher courses. The average learning curve was four to six months and coding professionals reported that they did not find ICD any more or less difficult to learn than ICD The information obtained through this study will be used, as appropriate, to move the regulatory process forward. Certainly, upper management should be represented as well as all departments affected in any way by the change.

The frequency of meetings will depend on the individual facility, as will the responsibilities of this task force. Obviously, coders and physicians will require training, but there are other individuals who will be affected and thus, will need some training depending on their involvement.

Training on the new coding system may take many forms including face-to-face workshops or seminars. Currently, there are a number of excellent coding publications dedicated to coding training, and it is expected that this, too, will be the case for ICDCM. Audioseminars, which deliver the information to a large audience, are very cost effective as no travel is involved.

Certainly, Web-based training will play an important role in the training of all affected individuals. Various methodologies should be employed as different groups of individuals might respond to one type of training more than another.

For instance, physicians may prefer face-to-face training to a Web-based training program. Educators in coding certificate programs, health information technology programs, and health information administration programs will have the task of educating new coders. As mentioned earlier, different populations of individuals will require training. Coding professionals: While ICDCM has many differences from ICDCM, the new classification system does retain the traditional format and many of the same characteristics and conventions and thus, should not be too difficult for experienced coders to achieve coding proficiency.

An additional problem that could be encountered is a shortage of credentialed, professional coders. Currently, there is a shortage of coders skilled in both ICDCM and CPT coding, and some coders may opt to retire before learning an entirely new system thus exacerbating the problem.

A primary user of ICD codes includes health care personnel, such as physicians and nurses, as well as medical coders, who assign ICDCM codes to verbatim or abstracted diagnosis or procedure information, and thus are originators of the ICD codes.

ICDCM codes are used for a variety of purposes, including statistics and for billing and claims reimbursement. Public health is largely a secondary user of coded data. Why change? Some noteworthy benefits include: Easier comparison of mortality and morbidity data Currently, the U. The greater level of detail in the new code sets includes laterality, severity, and complexity of disease conditions, which will enable more precise identification and tracking of specific conditions.

Terminology and disease classification are now consistent with new technology and current clinical practice. Injuries, poisonings and external causes are much more detailed in ICDCM, including the severity of injuries, and how and where injuries happened.

Extensions are also used to provide additional information for many injury codes. Pregnancy trimester is designated for ICDCM codes in the pregnancy, delivery and puerperium chapter. Postoperative codes are expanded and now distinguish between intraoperative and post-procedural complications. Get Email Updates. To receive email updates about this page, enter your email address: Email Address. What's this? Links with this icon indicate that you are leaving the CDC website.

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