Welcome

 Thank you for taking the time to visit the icd10 blog.  This blog has been created to prepare medical billers and coders for the 2013 ICD-10 implamentation.

As many of us know, in 2013 our familiar ICD-9-CM will be replaced by the ICD-10 nationwide. Volumes I and II of the ICD-9-CM will be replaced by the ICD-10-CM, and volume III of the ICD-9-CM will be replace by a second book, the ICD-10-PCS.

This is a brief introduction to some of the major changes that will be discussed further in depth in future entries.

Size and Volume:

The ICD-9-CM has about 14,025 code while the ICD-10-CM alone has over 68,000 and ICD-10-PCS has over 87,000. Code descriptions are also much more detailed and code have been created for future expansion.

Code Structure:

ICD-9-CM codes are tradditionaly 3-5 digits long, and with the exception of V and E codes, are mainly numeric. The ICD-10-CM codes are 7 digits in length and all begin with an alpha charecter. Digits 2 and 3 are numeric, and digits 4-7 can be either an alpha charecter or numeric in nature.

The ICD-10-PCS are also 7 digits in length and are alphanumeric. These codes do not utilize I and O though and are multi-axial.

Ex.
ICD-10-PCS code 0PQJ04Z - Repair of a fracture, radius w/internal fixation device: 

  • Digit 1 describes the section (Medical / Surgical - 0)
  • Digit 2 describes the body system (Upper bones - P)
  • Digit 3 describes the root operation (Repair - Q)
  • Digit 4 describes the body part (Left radius - J)
  • Digit 5 describes the approach (Open - 0)
  • Digit 6 describes the device (Internal fixation - 4)
  • Digit 7 describes a qualifier (None - Z)
Another interresting change to the codes structure is the "dummy place holder" which is represented by the letter X. The X allows for future expansion of codes.
 
The guidelines state that if  a code has an available 6th digit it must be used and must always reside in the 6th digit placement. This poses a problem for codes that are only 4 digits in length and have an available 6th digit option.  In this case you would code the first four digits, place the "X" as the fifth digit place holder, and then select the proper 6th digit.

EX.
 
T39.8X2 - Poisoning by other nonopioide, analgesics, and antipyretics, NEC, intentional self harm.
    ~ Note that the "X" is holding the 5th digit allowing the 2 to hold the 6th digit placement~

Book Structure:

**The following is a list of how ICD-10-CM codes are classified according to their three digit catagory**

1.A00-B99: Certain Infectious and Parasitic Diseases
2.C00-D49: Neoplasms
3.D50-D89: Diseases of the Blood and Blood Forming Organs and Certain Disorders Involving the Immune Mechanism
4.E00-E89: Endocrine, Nutritional and Metabolic Disease
5.F01-F99: Mental and Behavioral Disorders
6.G00-G99: Disease of the Nervous System
7.H00-H59: Diseases of the Eye and Adnexa
8.H60-H95: Diseases of the Ear and Mastoid Process
9.I00-I99: Diseases of the Circulatory System
10.J00-J99: Diseases of the Respiratory System
11.K00-K94: Diseases of the Digestive System
12.L00-L99: Diseases of the Skin and Subcutaneous Tissue
13.M00-M99: Diseases of the Musculoskeletal System and Connective Tissue
14.N00-N99: Diseases of the Genitourinary System
15.O00-O9A: Pregnancy, Childbirth, and the Puerperium
16.P00-P96: Certain Conditions Originating in the Perinatal Period
17.Q00-Q99: Congenital Malformations, Deformations, and Chromosomal Abnormalities
18.R00-R99: Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, NEC
19.S00-T88: Injury, Poisoning and Certain other Consequences of External Causes
20.V01-Y95: External Causes of Morbidity
21.Z00-Z99: Factors Influencing Health Status and Contact with Health Services

Other structural changes within the ICD-10-CM book include the deletion of hypertension table and additional, revised, and deleted guidelines.

The ICD-10-CM is still divided into an alphabetic index and a tabular index and still requirse propper look up and cross-referencing.

The ICD-10-PCS is divided following a different structure. Each digit in a three digit catagory  is assigned a specific meaning.

First  digits are used to assign sections and are as follows:


0 - Medical and Surgical

1 - Obstetrics
2 - Placement
3 - Administration
4 - Measurement and Monitoring
5 - Extracorporeal Assistance and Performance
6 - Extracorporeal Therapies
7 - Osteopathic
8 - Other Procedures
9 - Chiropractic
B - Imaging
C - Nuclear Medicine
D - Radiation Oncology
F - Physical Rehabilitation and Diagnostic Audiology
G - Mental Health
H - Substance Abuse Treatment


Second digits indicate the specific body system and are as follows:

0 - Central Nervous System
1 - Peripheral Nervous System
2 - Heart and Great Vessels
3 - Upper Arteries
4 - Lower Arteries
5 - Upper Veins
6 - Lower Veins
7 - Lymphatic and Hemic Systems
8 - Eye
9 - Ear, Nose, Sinus
B - Respiratory System
C - Mouth and Throat
D - Gastrointestinal System
F - Hepatobiliary System and Pancreas
G - Endocrine System
H - Skin and Breast
J - Subcutaneous Tissue and Fascia
K - Muscles
L - Tendons
M - Bursae and Ligaments
N - Head and Facial Bones
P - Upper Bones
Q - Lower Bones
R - Upper Joints
S - Lower Joints
T - Urinary System
U - Female Reproductive System
V - Male Reproductive System
W - Anatomical Regions, General
X - Anatomical Regions, Upper Extremities
Y - Anatomical Regions, Lower Extremities


 

Third digits indicate the specific type of operation and are as follows:


0 - Alteration: Modifying the anatomic structure of a body part without affecting the function of the body part

1 - Bypass: Altering the route of passage of the contents of a tubular body part

2 - Change: Taking our ot off a device from the body part and putting back an identical or similar device in or on the same body part without cutting or puncturing the skin or mucous membrane

3 - Medication Management: Monitoring and adjusting the use of medications for the treatment of a mental health disorder

4 - Group Counseling: The application of psychological methods to treat two or more individuals with addictive behavior

5 - Destruction: Physical eradication of all or a portion of a body part by the direct use of energy, force, or a destructive agent

6 - Counseling: The application of psychological methods to treat an individual with normal developmental issues and psychological problems in order to increase function, improve well-being, alleviate distress, maladjustment or resolve crises

7 - Dilation: Expanding an orifice or the lumen of a tubular body part

8 - Division: Cutting into a body part, without draining fluids and/or gases from the body part, in order to separate or transect a body part

9 - Drainage: Taking or letting out fluids and/or gases from a body part

B - Excision: Cutting out or off, without replacement, a portion of a body part 

C - Extirpation: Taking or cutting out solid matter from a body part

D - Extraction: Pulling or stripping out or off all or a portion of a body part by the use of force

F - Fragmentation: Breaking solid matter in a body part into pieces

G - Narcosynthesis: Administration of intravenous barbiturates in order to release suppressed or repressed thoughts
 
H - Insertion: Putting in a nonbiological appliance that monitors, assists, performs, or prevents a physiological function but does not physically take the place of a body part

J - Inspection: Visually and/or manually exploring a body part

K - Map: Locating the route of passage of electrical impulses and/or locating functional areas in a body part

L - Occlusion: Completely closing an orifice or the lumen of a tubular body part

M - Reattachment: Putting back in or on all or a portion of a separated body part to its normal location or other suitable location

N - Release: Freeing a body part from an abnormal physical constraint

P - Removal: Taking out or off a device from a body part

Q - Repair: Restoring, to the extent possible, a body part to its normal anatomic structure and function

R - Replacement: Putting in or on biological or synthetic material that physically takes the place and/or function of all or a portion of a body part

S - Reposition: Moving to its normal location, or other suitable location, all or a portion of a body part

T - Resection: Cutting out or off, without replacement, all of a body part

U - Supplement: Putting in or on biological or synthetic material that physically reinforces and/or augments the function of a portion of a body part

V - Restriction: Partially closing an orifice or the lumen of a tubular body part

W - Revision: Correcting, to the extent possible, a portion of a malfunctioning device or the position of a displaced device

X - Revision: Correcting, to the extent possible, a portion of a malfunctioning device or the position of a displaced device

Y - Transplantation: Putting in or on all or a portion of a living body part taken from another individual or animal to physically take the place and/or function of all or a portion of a similar body part

The remaining digits 4-7 are used to indicate body part, approach, device, and qualifier

 

 Ex. Three digit catagory 001: Medical and Surgical, Central Nervous System, Bypass

 

 

Guidelines:

Many of the ICD-9-CM guidelines are also in the ICD-10, including "code first", "use additional", "see also", "includes", ect. There are also new guidelines that have been added as well.  The traditional "excludes" notation has been divided into two, "exclude 1" and "exclude 2". There are also guidelines for the dummy place holder X , bilateral indications, and more. 

 

 

Posted by K.Rodecker at 2/12/2010 6:34 PM
Categories: uncategorized
 

What did you think of this article?




Trackbacks
Trackback specific URL for this post
  • No trackbacks exist for this post.
Comments
Display comments as (Linear | Threaded)

Leave a comment

Submitted comments are subject to moderation before being displayed.

 Enter the above security code (required)

 Name (required)

 Email (will not be published) (required)

 Website

Your comment is 0 characters limited to 3000 characters.