Home Health ICD-9/ICD-10 Alert

With ICD-10's 200 diabetes codes, just one code reports both the diabetes and the manifestation.

The Oct. 1, 2013 deadline may seem like a distant date, but it's not too early to begin preparing for ICD-10 implementation. Experts advise taking advantage of the lead time you have so you'll be truly prepared come cut-over.

ICD-10 will increase our inter-operability with other countries already on the newer diagnosis and procedure coding system, says Therese Rode, RHIT, HCS-D, senior coding manager with INOVAVA Home Health in Springfield, Vir.

ICD-10 can also capture newer procedures and diagnoses than the 30-year-old ICD-9 coding system can, Rode says.

Best of all, ICD-10 gives greater specificity in a single code. Now you'll be able to code bilateral ulcer, bilateral amputations, and bilateral fractures.

For example: With ICD-9, there's no clear way to report a patient with pressure ulcers on both the left and right buttocks. In ICD-10, you can easily report these bilateral ulcers with codes such as L89.323 (Pressure ulcer of left buttock, stage III) and L89.313 (Pressure ulcer of right buttock stage III).

"ICD-10 better captures the work you're doing and the patient's condition," Rode says.

By now you've probably already heard that while ICD-9 Volumes 1 & 2 contain only 13,000 codes, ICD-10 will up that number to 68,000 -- but don't let that growth scare you off.

The greater number of codes is due to the structure of the codes, Rode says. Don't be afraid of the growth. "You're not going to use them all," she adds.

Tip: In ICD-9, you need at least two codes to describe most diabetic manifestations. But with ICD-10's 200 diabetes codes, just one code reports both the diabetes and the manifestation.

The ICD-10 system is alpha-numeric, making room for a greater number of codes than ICD-9 could ever contain. The first three characters of an ICD-10 code indicate the code category, much like ICD-9 does now. The fourth character in ICD-10 indicates the etiology.

The fifth character indicates the anatomical site, and the sixth character lists the severity. A seventh, optional, character provides a place of service code.

Example: In ICD-9, to report a patient with a pressure ulcer on the right buttock you would list: 707.05 (Pressure ulcer; buttock) and 707.24 (Pressure ulcer stage IV). After ICD-10 is effective, you'll list L89.314d (Pressure ulcer of right buttock, stage IV; subsequent encounter).