General Surgery Coding Alert

Question: I appreciate the monthly ICD-10 example in your newsletter, but I don’t have a good understanding of the “big picture” differences between ICD-9 and ICD-10. Could you please outline those?

Arkansas Subscriber

Answer: If you learn these six basic differences you’ll have the “big picture:”

1. ICD-9 has 17 chapters; ICD-10 has 21 chapters.

2. ICD-9 codes are three to five characters, mostly numeric, while ICD-10 codes are alpha numeric and contain up to seven characters.

3. ICD-10 doesn’t break out the information represented by ICD-9 V and E codes, but incorporates the information into the main classification:

a. Placeholders (X) are required to hold places followed by additional characters.
b. Seventh characters are required for obstetrics, injuries, and external causes of injuries.
c. Post-operative complications will now be located with the procedure-specific body system.

4. ICD-9 classifies injury by type only, but ICD-10 classifies injuries first by specific site and then by type.

5. ICD-10 includes full code titles for all codes, so it is not necessary to reference back to common fourth and fifth digit categories.

6. ICD-10 has combination codes for conditions and common symptoms or manifestations, for example E10.21 (Type 1 diabetes mellitus with diabetic nephropathy).