Urology Coding Alert

Take advantage of the time you have to prepare for the coming changes.

Now is not too early to start your ICD-10 planning and preparation. The good news is that you’ll have a multitude of more specific urology diagnosis codes in categories such as vesicoureteral reflux and prostatitis.

The bad news is that you need to learn the new codes and make sure your software can handle ICD-10.

Although Oct. 1, 2013, may seem like eons away, the amount of work ahead of you between now and then might be daunting. That’s because you’ll have to be ready to change from the ICD-9 diagnosis coding system that you’ve become accustomed to and start using the new ICD-10 system.

More Codes Means More Specificity

The biggest change you’ll need to cope with is sheer numbers. The 2013 edition of the diagnosis coding manual will expand the code set from 17,000 codes, which ICD-9- CM currently has, to over 155,000 codes, which ICD-10 will include.

Your resources should currently be expended on training the coder who will be your coding point of contact, and developing a transition plan, said Jeanne Yoder, RHIA, CCS-P, CPC, CPC-I, during the Coding Institute audioconference, “ICD-10 Issues: Get Ready for the Conversion ASAP.”

Start preparing now by learning the basics. Here are some of the major differences you can expect out of ICD-10:

• More specificity. ICD-10 greatly expands the level of detail, but don’t let that scare you. For example, in ICD-9 you have four diagnosis codes for vesicoureteral reflux (593.70-593.73). In ICD-10, you’ll have 11 diagnosis codes (N13.70-N13.739). Plus, you’ll have four additional prostatitis codes to choose from with ICD-10.

While the codes can provide greater specificity, assigning them won’t necessarily require more detailed documentation. Other initiatives such as pay-forperformance and quality measures may require more detailed documentation. ICD-10 will simply provide the means for reporting that greater detail.

• Newer terminology. ICD-10-CM updates medical terminology and classification of disease to be consistent with current medical practice.

• More characters. Codes in ICD-10-CM are all alphanumeric and can be up to seven characters in length.

When a seventh character exists (referred to as an extension), it is to show episode of care, such as initial encounter, subsequent encounter, or sequelae, and other additional information.

For example, you’ll need to add a seventh digit to S30.201 (Contusion of unspecified external genital organ, male)

to identify an initial encounter (A), a subsequent encounter (D), or sequelae (S).

• More combination codes. ICD-10 combination codes provide detail that requires more than one code in ICD-9.

Avoid the ‘Use It or Lose It’ Factor Helpful hint: Once you’ve become familiar with ICD-10-CM and the way it works and looks, you’ll want to get some official training. But don’t get your staff trained too far in advance, warns Joanne Byron, LPN, BSNH, CHA, CMC, CPC, CPC-I, MCMC, PCS, CEO of the American Institute of Healthcare Compliance Inc., in an e-mail to members. If they can’t apply what they’ve learned, the “use it or lose it” factor will kick in.

Best bet: Wait until three to six months before the final implementation date, experts suggest. Two to three days of training should be adequate for coders already trained with ICD-9 to learn what they need to know to make the transition.

More information: To view the ICD-10 codes, visit this site: www.cdc.gov/nchs/about/otheract/icd9/icd10cm.htm. Stay tuned to Urology Coding Alert for more information as ICD-10 draws near.