Pathology/Lab Coding Alert

Heads up -- you-ll need some time to learn the ropes.

You thought getting ready for a host of new ICD-9 codes each October was rough. Wait until you have to replace the entire ICD-9 series with the new, overhauled ICD-10 codes -- in 2011, according to a recent Health and Human Services (HHS)announcement.

On Aug. 15, HHS announced its intention to replace the ICD-9 codes with the ICD-10 series effective Oct. 1, 2011. Not only would the new code set completely overhaul your claims systems, software, and superbills -- but it could require vast training for your staff.

Here's why: 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.

For instance: You-d list a diagnosis of malignant neoplasm of breast, nipple and areola as 174.0 under ICD-9, but as C50.0 under ICD-10, according to the current listing available on the Internet at www.who.int/classifications/apps/icd/icd10online/.

-We recognize that the transition to ICD-10 will require some upfront 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 CMS Acting Administrator Kerry Weems in a statement.

Many medical practices were surprised by the news of the impending ICD-10 implementation, despite the fact that CMS has been building the new code set for years.

-We-ve been thinking of ICD-10 as this far-away prospect that may never take hold,- says Heather Corcoran with CGH Billing. -The new announcement sort of brings us back to the reality that this will indeed take effect.-

The HHS took comments on the proposed ICD-10 code set and transaction standards. To read more, you can visit the CMS Web site at www.cms.hhs.gov/TransactionCodeSetsStands/02_TransactionsandCodeSetsRegulations.asp#TopOfPage.