Category Archives: ICD-10

International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10); ICD-10-CM, ICD-10-PCS; ICD-9-CM; ICD-10-CM Clinical Modification; inpatient coding standard; granular; granularity; specificity; GEMs; general equivalence mappings; transition to ICD-10; new coding rules; coding regulations

Coast to coast with ICD-10

We’re now almost two months into ICD-10. I’ve been, literally, coast to coast during that time and have asked everyone how their transition is going. To my surprise, regardless of where physician practices were in their preparation when ICD-10 was delayed last year, everyone that I’ve visited with was well prepared for this year’s Oct. 1 implementation.

Many practices used the extra time to work on dual coding, testing of clearinghouses, reviewing new LCD policies, etc. Some groups were glad the implementation date was pushed back, but equally as many were not, having to retrain coders and providers on the new code set. As mentioned last month, there have been a few bumps, but the only consistent comment I hear is about coder productivity and documentation. Continue reading

ICD-10 coding challenge: Legionnaire’s disease


An outbreak of Legionnaire’s disease has plagued residents of the South Bronx area of New York City this summer. At least 12 people have died from the disease and greater than 100 have been sickened by it. The source of the infection has been linked to water cooling towers in the area.

Assign the ICD-10-CM code for Legionella pneumonia. Continue reading

ICD-10: No news is good news

It seems that wishes are not just for fairy tales, they can come true after all. So far, it looks like the wish for an uneventful ICD-10 transition is a reality. Even the month-end report from CMS was fabulously dull.

The bottom line is, coding issues are historically a tiny percentage of the total claim denials, and that is just as true for ICD-10 as for ICD-9. Historically, total claim denials run around 10% of total, and of those, 2% are due to incomplete or invalid information of any kind, including things like provider ID. Both the 10% and the 2% statistic remained stable across the transition to ICD-10. Continue reading

ICD-10: One month in

October 1, 2015 has come and gone. I didn’t really expect everything to come to a screeching halt, as warned during the anticipation of Y2K. I did, however, expect that by the middle of this month, we would have some horror stories about claims issues with regard to the transition from ICD-9 to ICD-10. I’m still waiting. I’m sure there have been individual issues, but scanning list serves, web sites, CMS, etc., I haven’t seen any systemic issues with regard to claims payment in the professional, Part B world. Insert sigh of relief here. Continue reading

HIMagine That! ICD-10 fallout?

Donna: Hey, Sue! We haven’t talked since AHIMA. Did you get back in time for ICD-10 go-live?

Sue: Yes, I was in my office, bright and early on October 1. I couldn’t wait to see how it was going to go!

Donna: Well, I talked to a lot of people at AHIMA and it was clear the general mood was one of excitement. Finally, we’re able to move forward with ICD-10 after all these years of preparing and practicing.

Sue: I heard pretty much the same thing. One HIM director captured it perfectly when she said, “Bring it on!” I think everyone was confident, anxious to get going and ready to deal with the fallout, if any. Continue reading

ICD-10: Keep up the calm

Keep calm and carry on…that was the title of the first thing I ever wrote, in early 2010, about the hype surrounding ICD-10. Less than six months after the CMS final rule for implementation of ICD-10 on October 1, 2013, the engines of hysteria were already churning out alarmist rhetoric.

In a moment of nostalgia, I went looking for that article. Here are a couple of examples of ICD-10 sound bites that were popular in 2010, and my reaction to them. Continue reading

Value-based care is more than the new ICD-10

I’ve heard value-based care called “the new ICD-10.” I understand the comparison, at least in reference to regulatory disruption. But aside from the CMS willpower behind value-based care, I don’t see a lot of similarities.

I think of ICD-10 as a new language that requires translation within every system using ICD codes. All system users need some level of literacy training. Value-based care is this and more. It is like moving to another state—even another country—where the customs, geography and idioms of speech are entirely different. Continue reading

ICD-10: The road ahead

After decades of development, endless regulatory hurdles and multiple delays, the implementation date for ICD-10 has arrived. If ICD-10 had a theme song, it certainly would be “The Long and Winding Road” by the Beatles. “Don’t leave me standing here” is the lyric that sums up the frustrations of enduring repeated last minute delays. Finally, the healthcare industry will no longer be left standing in the past, chained to the out-of-date and inadequate ICD-9 coding system. Continue reading

You are ready

No more kicking this ICD-10 can down the road. It’s finally here.  We have all been waiting, planning, preparing, training, and yes, worrying. With ICD-10 only 24 hours away, will it be gloom and doom as some suggest? Will the sky really fall when ICD-10 becomes effective? How could it when there have been so many years of effort and dedication by so many from across the healthcare industry?

Continue reading

ICD-10-PCS: Let it evolve

Ten years ago I had the chance to make my job portable and work from home, so I moved to a small town called Florence that I “discovered” on the Oregon coast—a perfect jewel set down between forest and river and ocean.

It soon became apparent that my definition of “perfect jewel” had strings attached. I loved Florence as it was when I moved there, and I didn’t want it to change. The changes that occurred after I arrived—the new blocky condos right by the riverbank, the new housing developments chewing up more of the forest, the old fish market replaced by a cheap chain restaurant—were all changes for the worse, I thought. How dare they mess up my town! Florence was supposed to stay the way it looked in the snapshots in my head. Continue reading