ICD-9 to ICD-10

With over 68,000 codes, ICD-10 is more extensive than the former ICD-9.The increased specificity calls for more accuracy and a herculean preparation.MBC's ICD-10 trained coders come with a guarantee of ensuring complete success with the transition.

The transition from ICD-9 to ICD-10 is massive, with a fivefold increase in diagnosis codes to roughly 68,000. Claims will not be processed if a medical practice or insurance payer does not switch to ICD-10. The new coding system does not change the procedure for outpatient billing.

ICD-10 code set can have three, four, five, six, or seven characters. Most three-character codes are used as headings for categories of codes, which can further expand to four, five, or six characters to add more specific details regarding the diagnosis. A three-character category that has no further subdivision can be a stand-alone. The following three characters correspond to the related etiology: the cause of a disease or condition, anatomic site, severity, or other details. Finally, a seventh character is the most significant difference between ICD-9 and ICD-10 because the former does not provide a mechanism to track the details the seventh character offers.

Anatomy of ICD-10 codes

The most visible difference between ICD-9 and ICD-10 is the structure of the codes itself. The addition of codes in ICD-10 allows for the reporting of increased specificity, such as laterality, manifestation, and healing, and provides a mechanism for reporting new diseases and treatments. Over 68,000 codes will be added to the latest coding system, allowing greater specificity in the diagnosis documentation. Though this will benefit healthcare providers more, it will also present transition complications.

The expansive system will prove beneficial to the U.S. healthcare system by improving the tracking of data to measure the quality and safety of care and process claims for reimbursement, subsequently improving clinical, financial, and administrative performance. This switch to ICD-10 will bring to the providers:

• Enhanced operational processes by classifying details within codes to accurately process payments and reimbursements
• Exhaustive information on condition, comorbidities, severity, complications, and locations
• Detailed health reporting and analytics such as cost, utilization, and outcome
• Extended coding flexibility, done by increasing code length to seven characters
• Coding Practices forum with other experts and participants

Contact MBC for any issues related to ICD-10 code mapping, testing, implementation, or denial management strategies.