Doctor's Life Magazine, Tampa Bay Doctor's Life Tampa Bay Vol. 2 Issue 1, 2014 | Page 18

A LITTLE BACKGROUND

I am sure by now many of us have read articles and attended
webinars about ICD-10. How many codes? What do the codes
look like? I would be remiss if I didn’t take this moment to
mention a little about the ICD-10 (World Health Organization
developed) system that will be used in the United States starting
October 1st. ICD-10 is comprised of both ICD-10 CM and ICD10 PCS. ICD-10 CM will be utilized for the inpatient, outpatient,
and physician practice setting. Professional coders as well as in
some instances, providers will assign ICD-10 CM codes (as they
do in ICD-9 now).
ICD-10 PCS which stands for ICD-10 Procedural Coding
System will be used in the inpatient setting primarily. Coders in
this setting will assign the codes based upon the documentation of
physicians that admit patients to acute care facilities.
There are around 68,000 codes in the ICD-10 CM system
and around 87,000 codes in the ICD-10 PCS system. This is
a noteworthy enhancement from the 13,000 ICD-9 diagnosis
codes and 11,000 ICD-9 procedure codes that we currently
have available for coding. This vast increase is primarily due to
the increase in specificity. ICD-10 CM has increased the levels
of details on codes with specifics as they pertain to laterality,
acuity, site and stage to say the least. For instance providers
and professional coders typically assign code 305.1 in ICD-9
for Tobacco Use Disorder. In ICD-10 the detail has increased
to around 15 codes and is defined as Nicotine Dependence with
options for either unspecified, tobacco or other tobacco products.
This is then even further specified to options for uncomplicated, in
remission, with withdrawal, with other nicotine-induced disorders,
and with unspecified nicotine-induced disorders.
I have another great example- there are additional details
around injuries that identify the episode of care or encounter of the
patient’s treatment/diagnosis in ICD-10 CM. For example:
»» Initial encounters defined as when the patient is receiving
active treatment/first visit by that physician

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»» Subsequent encounters defined as after the active phase

of treatment and when the patient is receiving repeat or
routine care for the injury.
»» Sequela is assigned for complication or condition that arises
as a direct result of an injury
The ICD-10 codes look significantly different as well, foreign
to the ICD-9 fan, connoiss