President’s letter

Jackie Raymond, RHIA

January, 2010

ICD-10-CM and ICD-10-PCS

Implementation of new ICD-10 diagnoses and procedure codes will be effective October 1, 2013, and preparing for the transition to it from ICD-9 is a very large undertaking. Working for a health care provider, academic institution or a health plan, the project plan necessary to accomplish the transition from ICD-9 to ICD-10 takes careful planning and collaboration between finance, clinicians, IT, HIM and operational leaders.

A good overview of implementing ICD-10 is an executive briefing from the American Hospital Association “HIPAA Code Set Rule: ICD 10 Implementation”. If you are an AHA member, you can download copies of this resource at www.aha.org, click on "Issues" then "HIPAA".

The following ICD-10 sample timeline is from the North Carolina Healthcare Information and Communications Alliance, Inc. (NCHICA): http://www.nchica.org/hipaaresources/timeline.htm.

ICD-10 is ten times larger than ICD-9 with an overall greater specificity in code assignments. Other countries now live on ICD-10 report a 6-9 month production decrease for coders. No one is currently live on ICD-10 PCS (procedure coding system). ICD-10 Procedure Coding will be new for all. It is important to remember this is not solely an IT project. Coders and Physicians must undergo basic training in ICD-10 at least six months prior to October 1, 2013. Will the documentation contain enough detail to support the new system?

There will be a period of time where your systems need to support both ICD-9 and ICD-10 with payers and researchers trying to crosswalk ICD-9 to ICD-10 and back. Refer to the General Equivalence Mappings (GEM) by CMS. Similar to a foreign language, there isn’t always a one to one translation. You can go from ICD-9 to ICD-10 and have a list of codes; then go from ICD-10 back to ICD-9 and have additional codes.

In the Health Care Provider setting you need to begin a systems application inventory, listing each vendor, application name where ICD-9 codes are captured, stored, analyzed and reported. The current systems need to accommodate the expanded codes.

The 5010 mandate is the next generation of HIPAA transactions and code sets (electronic exchange of administrative and financial information between health care providers and health plans for patient care services). 5010 has an earlier compliance date (January 1, 2012) than ICD-10 as it serves as the foundation of electronic exchange.

Don’t forget your researchers and physician offices with standalone data bases currently collecting ICD-9 codes and reporting. These must also be incorporated in your application inventory. Industry analysts describe ICD-10 as possibly exceeding Y2K in cost and impact, further emphasizing why proper planning is so essential.

ICD-10-CM/PCS Myths & Facts:

Myth: Current Procedural Terminology (CPT) will be replaced by ICD-10-PCS

Fact: ICD-10-PCS will only be used for facility reporting of hospital inpatient procedures and will NOT affect the use of CPT.

Take advantage of the following AHIMA and MaHIMA resources in 2010:

AHIMA created a separate ICD-10 webpage with a long list of ICD-10 documents, FAQ’s, ICD Ten Newsletter and audio conferences at www.ahima.org/icd10/

MaHIMA ICD-10 educational plans for 2010 include:

Transitioning to ICD-10 for Coders. MaHIMA Winter Meeting, Marlboro, January 29, 2010

MaHIMA ICD-10 Summit, Dedham, March 31, 2010

ICD-10 Presentations, 6 State Meeting, Manchester, NH, May 2-4, 2010

Happy New Year, MaHIMA members! Please remember to visit often our new website at www.mahima.org.