ICD-10 An Overview
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Monday, 08 February 2010 19:43

ICD-10-CM/PCS -The Next Generation of Coding: The International Statistical Classification of Diseases and Related Health Problems (commonly known as ICD) is revised periodically and is currently in its tenth edition. The work on ICD-10, as it is therefore known, was begun in 1983 and was completed in 1992. The code set allows more than 140,000 different codes and allows tracking of many new diagnoses and procedures, a significant refinement from 17,000 codes available in ICD-9. Adoption was relatively rapid in most of the world.

Adoption of ICD-10 has been slow in the United States. Since 1988, the USA had required ICD-9-CM codes for Medicare and Medicaid claims, and most of the rest of the American Medical Industry followed. ICD-10 was adopted in 1999 for reporting mortality, but ICD-9-CM was still used as the data standard for reporting morbidity.

Revisions of the ICD-10 have progressed to incorporate both clinical code (ICD-10-CM) and procedure code (ICD-10-PCS).

  • ICD-10-CM, for diagnosis codes, is intended to replace volumes 1 and 2. The CM codes are more precise than those needed only for statistical groupings and trend analysis. The diagnosis classification system is developed by the Centers for Disease Control and Prevention. It is for use in all US Healthcare treatment settings. Diagnosis coding under this system uses 3–7 alpha and numeric digits.
  • ICD-10-PCS, for procedure codes, is intended to replace volume 3. The procedure classification system is developed by the Centers for Medicare & Medicaid Services (CMS) for use in the U.S. for inpatient hospital settings ONLY. The new procedure coding system uses 7 alpha or numeric digits.

The US Department of Health and Human Services (HHS) proposed new code sets to be used for reporting diagnoses and procedures on all health care transactions. Under the proposal, the ICD-9-CM code sets would be replaced with the ICD-10 code sets. Centers for Medicare and Medicaid Services has agreed and announced the compliance date for implementation of the ICD-10-CM/PCS, (Clinical Modification/Procedure Coding System) as October 1, 2013, for all covered entities.

ICD-10-CM/PCS will improve precise payment for services rendered and facilitate evaluation of medical processes and outcomes. A number of other countries have already moved to ICD-10, including United Kingdom, France, Australia, Germany, and Canada.

The current system, International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM) is old, outdated, and has disused terminology, uses outdated codes that provide imprecise and confined data, and is discrepant with current medical practice. It does not provide the necessary detail for patients’ medical conditions or the procedures and services performed on hospitalized patients. It cannot accurately describe the diagnoses and inpatient procedures of care delivered in the 21st century.

Last Updated on Tuesday, 28 September 2010 12:11

ICD-10 Corner

9 benefits of ICD-10

1. Measuring the quality, safety and efficacy of care
2. Designing payment systems and processing claims for reimbursement
3. Conducting research, epidemiological studies, and clinical trials
4. Setting health policy
5. Operational and strategic planning and designing healthcare delivery systems
6. Monitoring resource utilization
7. Improving clinical, financial, and administrative performance
8. Preventing and detecting healthcare fraud and abuse
9. Tracking public concerns and assessing risks of adverse public health events

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