Anesthesia Coding Alert

Coming soon: Changes to pain codes -- and everything else.

If you think keeping up with the new 2009 ICD-9 migraine and headache codes is tough, just wait. In just  three years, you might have more than 155,000 new codes to deal with.

What happened: On Aug. 15, the Department of Health and Human Services (HHS) announced a proposal to replace the ICD-9 codes with the ICD-10 series effective Oct. 1, 2011. Not only will this new code set require an overhaul of your claims systems, software, and superbills, it may require retraining for your entire staff.

A recent CMS MLN Matters (SE0832) states, "Compared to the current ICD-9 classification system, ICD-10 offers more detailed information and the ability to expand specificity and clinical information in order to capture advancements in clinical medicine. Providers may want to become familiar with the new coding system."

The ICD-9 code series you're familiar with includes about 17,000 codes. The ICD-10 code set contains more than 155,000 codes, including PCS codes. That's a lot to wrap your mind around. "We've been thinking of ICD-10 as this faraway prospect that may never take hold," says Heather Corcoran with CGH Billing in Louisville, Ky. "The new announcement sort of brings us back to the reality that this will indeed take effect."

What ICD-10 looks like: Currently, you'd code a patient presenting with low back pain with 724.2 (Lumbago). When ICD-10 goes into effect, it's likely you'd code the same patient with M54.5 (Low back pain), which includes loin pain, low back strain, and lumbago not otherwise specified, but excludes lumbago due to intervertebral disc displacement (M51.2X) or with sciatica (M54.4X). The hope is that these changes will result in an improved ability to measure health care services and enhance CMS's ability to conduct public health surveillance.

Bonus for coders: Another of ICD-10's goals is to decrease your need to include supporting documentation with claims, which should make both you and your physician happy. ICD-10 also includes updated medical terminology and classification of diseases -- among many other changes.

Get a head start: To read more about the ICD-10 changes, visit the CMS Web site at www.cms.hhs.gov/ICD10.