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Endocrine, Metabolic, and Nutritional Diseases, and Immune-System Disorders.
Last week, I ran across this very entertaining piece over in Healthcare Dive about the new ICD-10 codes. The International Classification of Diseases (ICD) is an incredibly useful tool in public health that basically can reduce an injury to a series of numbers. As you can imagine, this is very powerful when it comes to determining if something is on the rise. Researchers can easily count the number of times something occurs, and if it’s up from previous years, there might be something there.
Part of the beauty of the ICD-10 codes is how specific they are. The previous system, ICD-9 (creative, I know) wasn’t nearly as specific as they only had 13,000 codes compared to the 68,000 in ICD10. With the advent of ICD-10, The Powers That Be have gone into painstaking detail breaking down injuries, diseases and other maladies into incredible precise codes that can be used by researchers and public health professionals.
Today, we’re going to go through my favourite ones.
W55.89XA: Other contact with other mammals
There are many codes for contact with mammals. Raccoons, cows, pigs and cats are all represented. However, the mighty seal is not covered, which made Buster Bluth very sad. He would have suffered from W55.89XA.
W61.12XA: Struck by macaw, initial encounter.
Look like our patient
*puts on sunglasses*
Is a little Macaw-struck
(The other option here was for an AC/DC reference…)
V97.33XD: Sucked into jet engine, subsequent encounter.
Now, I’m not an MD. But, if you are getting sucked into a jet engine on more than one occasion, you may want to re-evaluate your life choices.
W22.02XD: Walked into lamppost, subsequent encounter.
I don’t really know if going to see a doctor is the best solution here, or just looking where you’re going. I do imagine this being on the rise as the epidemic of texting and walking continues to rise.
(Ed note: Subsequent encounter here means they have seen the doctor previously for the same complaint, not that they have done it several times, even though the latter does make it funnier).
I also looked at some and realized they could be for superheroes…
T63.301A: Toxic effect of unspecified spider venom, accidental (unintentional), initial encounter
Spiderman, spiderman, does whatever a T-63-301-A can!
T75.01XA: Shock due to being struck by lightning, initial encounter
When he was hit by lightning, Barry Allen turned from a police scientist to become The Flash! One of the greatest superheroes of the Silver Age!
W88.1: Exposure to ionizing radiation
HULK NO LIKE BAD CODES. HULK LIKE WELL CATEGORIZED DATA. HULK LIKE PUBLIC HEALTH.
And my favourite code in the ICD10 manual:
V91.07XA: Burn due to water-skis on fire, initial encounter
Frankly, if you manage to set water-skis on fire, I’m not sure whether I want to give you a hi-five, a Darwin award, or video the whole thing for YouTube. I’m not even mad, that’s amazing.
While I make fun of the codes, they’re incredibly useful for public health and for collecting data. Knowing person, place and time, i.e. this idea of who is getting injured, where they’re hurting themselves and how can make all the difference when it comes to analyzing data and creating programs to prevent these injuries and illnesses from occurring. Whenever you present to a doctor, if they record the information that will allow for your ailments to be categorized using the ICD10 system, it goes a long way to helping researchers figure out what is going on at a macro, population level.
“Oh no! What happened?” “W220.2XD: Walked into lamppost, subsequent encounter.” by Public Health, unless otherwise expressly stated, is licensed under a Creative Commons Attribution 3.0 Unported License.
Harry Goldsmith, DPM demonstrates how to crosswalk ICD-9 and ICD-10 codes using the crosswalk feature on APMA’s Coding Resource Center.
Information, Ideas, Opinions & Ramblings from a Health Care Information Consultant
Are you a professional medical coder? Then you have an important job, because your careful coding is vital for proper diagnoses, to monitor the health of the general population, accurate reimbursement, the smooth operation of facilities that provide medical care and more. That’s why a firm understanding and comprehensive training for the ICD-10 transition will be incremental to your medical coding career.ICD-10 will replace ICD-9 on October 1, 2013 as the Unites State’s industry-wide coding system. Don’t stress. According to the AAPC, ICD-10-CM shares many similarities with ICD-9-CM, like the guidelines, conventions and rules. Anyone who is qualified to code ICD-9-CM should be able to easily make the transition to ICD-10-CM coding with the proper training. However, as a professional medical coder, there are several important differences between the two coding systems that you will need to prepare for.According to the AAPC, Major Differences Between ICD-9-CM and ICD-10-CM Include:
ICD-9-CM is mostly made up of numeric codes with three to five digits. ICD-10-CM will consist of alphanumeric codes with three to seven digits. The expanded characters of the diagnosis codes will provide more information concerning disease type, severity and anatomic site.
ICD-9-CM has about 13,600 codes and ICD-10-CM will consist of approximately 69,000 codes.
A single ICD-10-CM code can be found to not only pinpoint a particular disease, but also its current manifestation.
The current ICD-9-CM coding system does not require mapping. A two-year transition period, will allow access to both ICD-9 and ICD-10 coding systems until the transition is complete. Mapping will be required so that equivalent codes can be found for outcomes studies, medical necessity edits and more.
These major differences will impact information technology and software. The transition to ICD-10-CM will help solve certain challenges that exist with the ICD-9-CM coding system. In fact, according to the American Medical Association (AMA), a primary concern today with ICD-9 is the lack of specificity of the information conveyed in the codes. The ICD-10 coding system seeks to ratify this challenge with characters in the code that identify left or right, initial encounter versus subsequent encounter and other important clinical information. With ICD-10, codes will increase in detail, offering more information, and also, greater laterality.Another challenge with ICD-9 is that some of the chapters have reached capacity, so there is no way to add new codes. To help ratify this, new codes have been assigned to various chapters. However, this often makes it difficult for these codes to be located. Under the ICD-10 coding system, codes have increased in character length, which greatly increases the number of codes for future use and decreases the chances that chapters will run out of codes.Overall, the move from ICD-9 code sets to ICD-10 code sets will mean more details, terminology changes and expanded concepts for laterality, injuries and other related factors. According to the AMA, while the complexity of ICD-10 will provide many benefits, the complexity also enhances the need for comprehensive ICD-10 training in order to fully grasp the changes that accompany the new code sets.Early ICD-10 preparation is a smart choice. With advanced preparation, you can allow yourself adequate time to grasp all the necessary changes, as well as increase your marketability to health care facilities, doctors and more, who will need ICD-10 trained individuals to help ensure a smooth transition.Consider taking an online ICD-10 course and enjoy the flexibility of self-paced learning that allows you to keep your career on track, focus on other personal responsibilities when needed and study 24/7 – in other words, when it’s most convenient for you. Before you know it, the October 1, 2013 deadline will be here, so take charge, seek out flexible, online ICD-10 training and gain the peace-of-mind and career edge you deserve.
By Kim Carr, RHIT, CCS, CDIP, CCDS
July 15th, 2014
Confused about ICD-10 implementation and what you should be doing? You’re not alone.
The one-year implementation delay to October 1, 2015, has left many healthcare organizations in a quandary over what they should be doing and when.
A scheduled session on ICD-10 implementation at this year’s McKesson Homecare & Hospice National Users’ Conference took on a new focus when the delay was announced just before the conference. Many of those who attended shared their stories of ICD-10 preparedness at their agencies. Here are some of the comments we heard:
- One agency created a new position, a clinical care coordinator to help with coding and documentation. With salary plus training, it turned out to be quite a chunk of money.
- Another agency spent money on training, on books, and hired a per diem coder who is certified in ICD-9 and ICD-10.
- An agency executive said staff remain focused on the clinical side, with all monthly in-service presentations being on assessment. Doing this for the entire year should prepare the agency with the right documentation for coding. The agency spent money on books and education for managers, planning to start dual coding this summer. Those plans, however, remain up in the air.
- Coders at one agency are doing dual coding 25% of the time, a practice that may continue despite the implementation delay.
- One agency has been outsourcing coding for 18 months because staff coders didn’t want to learn ICD-10. It also outsources OASIS reviews. The agency’s average days in A/R is 14, where it used to be 21 days. The coding company uses McKesson, so the agency gives the coding company access to agency systems.
A recent test by CMS indicates that many providers are ready for ICD-10. A March test of 127,000 Medicare fee-for-service claims from 2,600 providers (including home health agencies) showed an 89% acceptance rate, CMS reported in June. Some regions had acceptance rates of 99%. Usual claims acceptance rates average 95%-98%.
McKesson Homecare™ and McKesson Hospice™ already feature the ability to dual code, so you can use this delay for your agency to stay on top of this important change.