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ICD-10 Presentation


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ICD-10 Presentation

  1. 1. Setting Standards For ICD-10 Training And Implementation
  2. 2. What is ICD-10?The International Statistical Classification of Diseasesand Related Health Problems (most commonly knownby the abbreviation ICD) published by the WorldHealth Organization (WHO) provides codes to classifydiseases and a wide variety ofsigns, symptoms, abnormalfindings, complaints, social circumstances, andexternal causes of injury or disease. Under thissystem, every health condition/situation can beassigned to a unique category and given a code.
  3. 3. ICD is a coding system of diseases and signs,symptoms, abnormal findings, complaints, socialcircumstances and external causes of injury ordiseases that is used internationally to classifymorbidity and mortality data for vital health statisticstracking and in the U.S. for health insurance claimreimbursement.The ICD is revised periodically and is currently in itstenth edition in most of the nations except a few likeUnited States which still is continuing to use theprevious edition, i.e. ICD-9.
  4. 4. Countries Year of AdoptionUnited Kingdom 1995Nordic Countries 1997 France 1997 Australia 1998 Belgium 1999 Germany 2000 Canada 2001
  5. 5. Change TimeLine Upgrade of formats for HIPAA transactions January 1, 5010 between 2012 payers andFederal providersMandate Upgrade of October diagnoses and 1, 2013 procedures ICD-10 used on October clinical 1, 2014 transactions
  6. 6. Diagnosis Codes ICD-9 ICD-10 3-5 Digits 3-7 DigitsFirst Digit is alpha (E-V) or First Digit Alpha Numeric Digits 2-5 are Numeric Digits 3-7 are Alpha or NumericTotal of nearly 13,000 codes More than 68,000 codes
  7. 7. Procedure Codes ICD-9 ICD-10 3-4 Digits 7 Digits All Digits are Numeric Each Digit is Either Alpha or NumericTotal of nearly 3,000 codes More than 87,000 codes Based on Outdated Use Current Medical Methodologies Terminology & DevicesGeneric Body Part Codes Specific Body Part Codes
  8. 8.  ICD-9 is 30 years old system No more room to add new codes Improved ability to measure health care services Increased sensitivity when refining grouping and reimbursement methodologies Enhanced ability to conduct public health surveillance Decreased need to include supporting documentation with claims
  9. 9. ICD-9 Code Format ICD-10 Code FormatX X X X X X X X X X X X Category Etiology, Category Etiology, Extension Anatomic site, Anatomic site, Manifestation Manifestation
  10. 10. Providers will not be able to continue toreport ICD-9-CM codes for servicesprovided on or after October 1, 2014.Your claims will not be paid if you are notprepared for this compliance.
  11. 11. - Concern and anxiety for organizations - and individualsExcitement due to manyadvantages of using ICD-10
  12. 12. A study sponsored by National Committee on Vital and Health Statistics (NCVHS) and conducted by the RAND Corporation Factors: Cost of training, productivity loss and system changesConclusion: Benefits outweighed the costsBenefits Included: More accurate payment, fewer rejectedclaims, and patient benefits including improved diseasemanagement and timelier intervention of emergent diseases,such as SARS which cost the Asian economy more than $10billion
  13. 13.  Endorsed by the World Health Organization (WHO) ICD-10 currently used in all other industrial countries With all countries on the same system, WHO and CDC can have more accurate and consistent health records ICD-9 system of three-digit categories and no more than 10 subcategories can no longer accurately track
  14. 14. CMS provides timelines for various sizes oforganizations at
  15. 15.  Identify Current Systems and Work Processes Communicate with Practice Management System Vendor
  16. 16.  Communicate with Your Payers about Your Contracts Communicate with Your Billing Service, Clearinghouse and Payers Identify Changes to Practice Work Flow and Business Processes Identify Staff Training Needs
  17. 17.  Training and continuing education Workflow changes Reimbursement delays Test - Test - Test Start Now!
  18. 18. Thank YouFor more Details about ICD-10 Training & Certification Please Visit: