By Mark Kaufmann, MD
In the mid-1800s, European statisticians gathered in France to make the world’s first formal attempt to list conditions describing known causes of morbidity and mortality, and every single way a person could get sick or die. Now, 150 years later, we are trying to master the nuances of the latest iteration of that idea: The Tenth Edition of the International Classification of Diseases — Clinical Modification, or ICD-10-CM.
ICD-10-CM features 68,000 codes — 54,000 more codes than ICD-9-CM — that give a much more logical, granular, and specific list of code definitions that reflect current trends of health care and technology for patient care.
The ICD-10-CM manual is about the size of a phone book. It includes more than 1,100 pages of diagnoses codes. The index alone — the guide to figuring out where to find the right diagnoses code — is 421 pages. That’s a lot to take in by Oct. 1, 2014, when you’ll be required to start using the ICD-10-CM code set.
On Oct. 1, you will need to start reporting patient diagnoses on your claims using this new coding standard. Dermatology practices, and the rest of the health care industry, will need to start using this new code set by this critical date. Failure to do so will result in significant financial disruption because claims filed using ICD-9-CM on and after Oct. 1 will be denied as unprocessable due to invalid codes.
This example illustrates how the ICD-10-CM codes break down. The first three characters in the code define the category for the condition being managed. The fourth character defines specific anatomic location, and the fifth character defines the etiology of that condition. Finally, the sixth character defines the laterality (left or right) for the condition. Learn more about the ICD-9 format differs versus the ICD-10 format here.
Don’t delay! Start your transition plan today
If your practice hasn’t initiated an implementation plan, don’t delay! Now is the time to start. Whether you’ve started the implementation process yet or not, March is the optimal month to gauge your current level of preparedness.
During the week of March 3-7, the Centers for Medicare and Medicaid Services (CMS) will conduct ICD-10-CM end-to-end testing. This means that providers will be able to submit real-time test claims and, in return, providers will receive electronic acknowledgement confirming that the submitted test claims were either accepted or rejected. To participate, dermatology practices must register with their local Medicare Administrative Contractors (MACs) using the MAC registration sites. The Academy has compiled links to regional MACs that allow members easy access to registration information in their areas.
To help members prepare for the Oct. 1 deadline, the Academy offers a wealth of free resources, including:
Take advantage of these resources that are designed to help you with your practice’s transition to ICD-10.
Dr. Kaufmann is associate clinical professor in the department of dermatology at Icahn School of Medicine at Mount Sinai in New York. He is also the chair of the AAD EHR Implementation Task Force and the ICD-10-CM Workgroup.
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