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February 11, 2014 - USA Health System Transitioning to ICD-10
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ICD-10_02-web.jpgThe University of South Alabama Health System is in the process of transitioning to an updated version of a health care classification system called the International Classification of Diseases (ICD).

Published by the World Health Organization, ICD is the standard diagnostic tool for epidemiology, health management and clinical purposes. It provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease. Under this system, every health condition and situation can be assigned to a unique category and assigned a code.

The ICD is revised periodically and is currently in its tenth edition in most nations. The United States, however, currently uses the previous edition, ICD-9. The ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by the ICD-10 codes for services provided on or after Oct. 1, 2014.

According to Jeffrey Morris, ICD-10 clinical documentation improvement specialist for the USA Health System, the most noticeable difference between ICD-9 and ICD-10 is the appearance and structure of the codes. “Unlike ICD-9 codes, ICD-10 codes are alphanumeric and contain three to seven characters,” he said. “The other difference is the increased specificity and granularity of ICD-10. The codes will paint a more accurate picture of what is going on with the patient and how severe a particular condition is.”

Dr. Charles Hamm, professor of pediatrics and lead physician for the transition, said most of the diagnostic coding changes are things that health care providers think about while treating a patient but aren’t documented because they are unable to be coded in ICD-9. For example, there are not separate ICD-9 codes for laterality or chronicity of an ear infection. ICD-10-CM will also allow for greater detail for conditions such as injuries and poisonings.

Currently, there are approximately 13,000 ICD-9 diagnosis codes that will expand to approximately 68,000 ICD-10 diagnosis codes. Also currently, there are approximately 3,000 ICD-9 procedure codes that will expand to approximately 87,000 ICD-10 procedure codes.

Injuries account for a great deal of the expansion of the diagnosis codes. There are many more specific anatomical code choices as well as codes that specify the laterality of the injury and the episode of care in which the patient is being seen. Also, the designation of trimesters and fetuses in obstetrics is new and adds to the expansion.

Any system that requires an ICD-9 code must be updated to accommodate the new structure of the ICD-10 codes. The system that the coders used must be upgraded, as well as billing programs and any databases that use an ICD-9 code for research or data collection.

Providers within the USA Health System will receive training – slated to start Spring 2014 – that is relevant to their particular specialty. General awareness training has already begun for all specialties. Admitting staff, business office staff, nursing, and other ancillary departments will also need general awareness training prior to the implementation date.

Both USA hospitals and the USA Health Services Foundation have intranet pages dedicated to ICD-10, coding, and documentation. For further information, contact Morris at jwmorris@health.southalabama.edu.

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