Urology Coding Alert

You're busy updating your diagnosis coding to incorporate the ICD-9 Codes 2009 changes -- and you only have three years left until the ICD-9 series is replaced by the new, overhauled ICD-10 diagnosis codes , according to a recent Department of Health and Human Services (HHS) announcement.

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.

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.

Many medical practices were surprised by the news of the pending 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 faraway 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."

"What this means is massive changes to all com-puter bases and programming and charge masters and codes. Nothing [presently] in existence can be used. Coders will need to be retrained and retested for certification," says Quin Buechner, MS, M. Div, ACS-FP/GI/PEDS, CPC, CCP, CMSCS, of ProActive Con-sultants in Cumberland, Wis. "The expense for small and even medium practices could be so overwhelming, they'd need to close or sell out."

"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 healthcare and other initiatives," said CMS Acting Administrator Kerry Weems in a statement.

Speak your mind: HHS is currently seeking comments on the proposed ICD-10 code set and trans-action standards by Oct. 21. To read more, you can visit the CMS Web site at http://www.cms.hhs.gov/TransactionCodeSetsStands/02_TransactionsandCodeSetsRegulations.asp.

"Now is the time for action," Buechner says. "ICD-10 is expensive and not clinically necessary for professional services. It is possibly of use in the hospital setting for procedure coding, but that is open to debate. The so-called 'improvement' from 17,000 codes to 155,000 codes is not an improvement at all when one thinks about it. In ICD-9 we do not use all the codes available for clinical work, partly because the split down to the most minute and minuscule variation of a disease process is really not necessary for clinical work. This is a call for you to register your protest with your Congressperson."