New Coding Guide Makes Learning ICD-10 Simple

New Coding Guide Makes Learning ICD-10 Simple

Reviewed by Linda J. Williamson, ART, CCS

ICD-10 Made Easy is the first book to be produced jointly by Medicode and St. Anthony Publishing (now known as Ingenix Publishing Inc.) since their merger in 1998. It is easy to read and gives practical guidance and advice to coders on the implementation of ICD-10, expected in October 2001.

ICD-10 Made Easy has six chapters with an appendix devoted to informing and instructing in the use of the new coding system. Chapter 1 outlines the modifications to ICD-10-CM that sets it apart from ICD-9. The most obvious is the new alphanumeric codes and the fact that the chapters increased from 17 chapters with two supplementary classifications to 21 chapters. Coders will have to be especially cognizant of the I and O alpha characters and not confuse them with the numbers 1 and 0. The best way to do this is to remember that the first character is always alphabetic. U is the only letter that is not used.

Chapter 2 covers the coding conventions, and the reader may be relieved to find that most of what we are familiar with in ICD-9 is still a part of ICD-10-CM. There are three character categories, four character subcategories and five and six character subdivisions. As in ICD-9, if there is a fourth, fifth or sixth character subdivision, then using a three-character code is invalid.

Chapter 3 details code “families” or blocks of three character categories each chapter contains. It is clear and easy to follow with many examples and repetitive reminders. Differences between ICD-9 and ICD-10-CM are highlighted and the margins contain “key points” for the reader.

Implementation is covered in Chapter 4. The suggestions are helpful and cover areas that managers may not have considered. For example, while those of us who code medical records every day are aware of the changes coming, departments like information management or the business office and vendors will be affected by the change and should be included in all education and task force meetings.

Physicians will also feel the impact of the change. ICD-10 Made Easy reminds us that this is a great educational opportunity to reach out to physicians and to start early to show them the level of detail that will be required to code accurately. Many codes are much more specific and require more detailed documentation than they have in the past.

Critical issues exist for the software and the information management systems department also. The difference in the structure between ICD-9 and ICD-10-CM may require software modifications, such as fields that accommodate up to six characters that will now be alphanumeric. Reprogramming may be necessary to distinguish between I, O and 1, 0. The specific length of descriptions may also pose a reprogramming problem.

Chapter 4 may be the most thought-provoking chapter in the book in terms of beginning to consider how we will successfully negotiate a smooth transition in our individual facilities.

Chapter 5 looks at procedural coding. For a number of years we have had parallel coding with ICD-9 and CPT-4. As we are all aware, 3M was chosen by the Health Care Financing Administration (HCFA) to design an alphanumeric procedure coding system to be implemented at the same time as ICD-10-CM. Their seven-character code structure in ICD-10-PCS is sequenced to the procedure, the approach and the organ. Each term has a specific definition. There is no diagnostic information. This chapter gives an overview of how that system is set up. ICD-10 Made Easy points out that although change is coming because ICD-9 and CPT-4 can no longer accommodate the coding needs, ICD-10-PCS will probably not be adopted without CPT-5 being considered. The American Medical Association (AMA) is currently in the research phase of CPT-5, having started later than 3M. At this printing there is no preview of the changes in CPT. Which system will become the industry standard and when the conversion will take place are not known.

The final chapter of ICD-10 Made Easy is called Documentation Index and lists medical conditions that will require more information to code in ICD-10-CM. The suggestion is made that this listing may be useful in doing chart audits for individual physicians to determine areas for improvement in documentation. This suggestion is worth taking and is made easier by the information in this chapter.

ICD-10 Made Easy is an instructional guide with key points highlighted, end of chapter questions and timely suggestions all geared to assist coders and managers in getting ready for October 2001 and the coding transition. It’s not too early to begin preparing, as documentation considerations, software reprogramming and training do not happen overnight.

* This book may be obtained from Ingenix Publishing by calling (800) 999-4600 or by visiting www.ingenix.com. *

Linda J. Williamson is a coding specialist in the health information department at Henry Medical Center in Stockbridge, GA.

ICD-10 Made Easy

1999, Ingenix Publishing Inc., $79.95

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