Orthopedic Coding Alert

Question: I heard the Dept. of Health and Human Services (HHS) announced when we-ll have to contend with ICD-10. What is that date, and what will this change involve? Will it really happen?

New York Subscriber

Answer: You-re right. The HHS delivered a whammy in August with its announcement that ICD-10 codes aren't too far away. On Aug. 15, HHS announced its proposal to replace the ICD-9 codes with the ICD-10 series effective Oct. 1, 2011.

The plan: Not only would the new code set completely overhaul your claims systems, software, and superbills -- but it could require significant training for you as a coder. In other words, you cannot use anything presently in existence. Codes

may have to be retrained and retested for certification. The cost to small and medium practices could be overwhelming.

Example: Right now, you should report 733.00 for "Osteoporosis, unspecified." With ICD-10, you-ll report M81.8 (Other osteoporosis without current pathological fracture). Notice you-ll have to know the patient does not have a pathological

fracture. The ICD-9 code series includes 17,000 codes. The ICD-10 code set, however, contains over 155,000 codes that you-ll have to wrap your brain around if it's implemented as HHS hopes it will be.

"We recognize that the transition to ICD-10 will require some up-front costs, but each year of delay would create additional costs, both because of the limitations of ICD-9 and because of the need to employ the greater precision that ICD-10 codes

provide to support value-based purchasing of health care and other initiatives," said Kerry Weems, CMS Acting Administrator .

Many healthcare organizations have come forward to add weight to the arguments against the 2011 implementation date. The Blue Cross Blue Shield Association, for example, says that the proposed timeline is "completely inadequate" and

"unworkable." To read more about the BCBS statement against ICD-10 implementation in two years, visit www.bcbs.com/issues/healthit/background/bcbsa-icd-10-meltdown.html.

Stay tuned: Keep watching future issues of the Orthopedic Coding Alert for the latest information.