Question

The coding system, ICD-10-CM, went into effect in October 2015. For this discussion, review the 2015 Top 50 ICD-10 codes for Family Practice. Select a code that interests you and research it further. For your post, address the following about your selected code:

• List the code and code description.
• How does the new ICD-10-CM code differ from the ICD-9-CM code?
  • Compare and contrast the ICD-9-CM code with the new ICD-10-CM code.

Answer 1

The ICD-10 code sets are not a simple update of the ICD-9 code set. The ICD-10 code sets have fundamental changes in structure and concepts that make them very different from ICD-9. Because of these differences, it is important to develop a preliminary understanding of the changes from ICD-9 to ICD-10.

DIFFERENCES BETWEEN ICD 10 AND ICD 9 CODES

ICD 10	ICD 9
Ratified in 2015	Ratified in 1975
More specific in coding	Less specific in coding
Digit 1 is alpha; digits 2 and 3 are numericdigits 4-7 are alpha or numeric Alert	First digit may be alpha (E or V) or numeric; digits 2-5 are numeric
able to add new codes	Unable to add new codes
More flexible	Less flexible
Contains 22 chapters	Contains 17 chapters
Having alpha numerical coding system	Have numerical coding system
Have extensions of episodes of care	Dose not have extension of episodes of care
External cause codes no more a supplimentary classification	There is a supplimentary classification for external cause
There is inclusion of trimester in obstetric codes	No inclusion was provided
Having 71924 codes for diagnosis and 69823 codes for procedure	Having 3824 codes for diagnosis and 14025 codes for procedure
Generally specific in every descriptions	Limited detail in many conditions

COMPARISONS BETWEEN ICD 10 AND ICD 9 MANUAL

1.Based on diagnosis sets

ICD-9	ICD 10
3-5 characters in length	3-7 characters in length
Approximately 13,000 codes	Approximately 68,000 codes
First digit may be alpha (E or V) or numeric; digits 2-5 are numeric	Digit 1 is alpha; digits 2 and 3 are numericdigits 4-7 are alpha or numeric Alert
Limited space for adding new codes	Flexible for adding new codes
Lacks detail	Very specific
Lacks laterality	Has laterality (i.e., codes identifying right vs.left)

     

• Unlike the diagnosis code set of ICD 9, the alpha characters in the ICD 10 diagnosis code set are not case sensitive.
• ICD 10 diagnosis code set features more characters, thus providing better details regarding a disease, severity of the disease and more precise anatomic site. Characters 1 to 3 indicate the category.
• Characters 4 to 6 indicate the etiology, disease severity, anatomic site and any other clinical details. The 7^th character is an extension that provides additional information.
• The expanded number of characters of the ICD-10 diagnosis codes provides greater specificity to identify disease etiology, anatomic site, and severity.

For example, if we compare ICD 10 and ICD 9 manuel

ICD-9 Diagnosis Codes	ICD-10 Diagnosis Codes
157 Malignant neoplasm of pancreas 157.0 Head of pancreas 157.1 Body of pancreas 157.2 Tail of pancreas 157.3 Pancreatic duct 157.4 Islets of Langerhans    157.8 Other specified sites of pancreas 157.9 Pancreas part unspecified	S52.5 Fracture of lower end of radius S52.5 Fracture of lower end of radius S52.521 Torus fracture of lower end of right radius S52.521A Torus fracture of lower end of right   radius, initial encounter for closed fracture

• The ICD-10 diagnosis code set also expands on the use of combination codes. Combination codes are a single code that can be used to classify 1) two diagnoses, or 2) a diagnosis with an associated secondary process or a diagnosis with an associated complication.

Eg:   In ICD-9 Diagnosis Codes It is listed as 415.0 Acute cor pulmonale And 415.12 Septic pulmonary embolism where as in ICD 10 It is seen as I26.01 Septic pulmonary embolism with acute cor pulmonale

2. BASED ON PROCEDURE CODES

ICD 9	ICD 10
3-4 numbers in length	7 alpha-numeric characters in length
Approximately 3,000 codes	Approximately 87,000 available codes
Based on outdated technology	Reflects current usage of medical terminology and devices
Limited space for adding new codes	Flexible for adding new codes
Lacks detail	Very specific
Lacks laterality	Has laterality
Generic terms for body parts	Detailed descriptions for body parts
Lacks descriptions of methodology and approach for procedures	Provides detailed descriptions of methodology and approach for procedures
Lacks precision to adequately define procedures	Precisely defines procedures with detail regarding body part, approach, any device used, and qualifying information

• Rather than this , the ICD-10 procedure code set allows for identifying the body system, root operation, body part, approach, and device involved in the procedure which includes charector and definition.
• The letters “O” and “I” are not in the code set. This is to ensure there is no confusion between the letters and the number 0 and 1.
• The 7 characters in the procedure code set help in providing very precise details. The first character identifies the section name. The second character identifies the system of the body. The third character identifies the basic operation.
• The fourth character identifies the part of the body. The fifth character indicates the approach. The sixth character identifies the device and the seventh character indicates the qualifier.

For example ,

In ICD-9 Procedure Code it is mentioned,39.50 Angioplasty ;39.31 Suture of artery 47.01 Laparoscopic appendectomy where as in ICD-10 Diagnosis Code it is elaporated as 0DN90ZZ Release of duodenum, open approach 0FB03ZX Excision of liver, percutaneous approach, diagnostic 02PS0CZ Removal, extraluminal device from pulmonary vein, right, open .