Insights From Our Editors

How Many More Codes are in ICD-10 versus ICD-9?

July 29, 2015

On Oct. 1, ICD-10 will be implemented, and it’s considerably more complex. The Vision Source Navigation Guide to Health Care Reform notes that there are 68,000 codes in ICD-10 compared to the 13,000 codes in ICD-9, adding additional specificity on disease diagnosis, severity and treatment stages.

Identify the top 25 diagnosis codes you use in your office. Have your staff use your practice management software to code these top 25 in ICD-10 codes.

Update your processes
The most important process to update is your clinical documentation. Make sure your clinical documentation captures the new coding requirements. These requirements are:
a) For all codes – Laterality (right, left, bilateral)

b) For diabetes
• Type of diabetes
• Diabetic ocular complication
• Presence of macular edema

c) For glaucoma
• The specific type of glaucoma
• The stage of glaucoma

d) For trauma
• The first code is for the eye problem
• Then, you code the trauma
i. Where did it happen
ii. What was the activity at the time
iii. What was the injury
iv.What were the other injuries that occurred

The second most important process to make sure is ready are the steps from clinical documentation to claim submission. Identify these steps in your office and make sure you have worked out all the bugs.

Talk to your vendors and health plans
Make sure all the health plans, clearinghouses and third-party billing services you work with are ready for ICD-10 coding.

Test your systems and processes
Ask all of your health plans, clearinghouses and third-party billing services about testing before October 1, 2015. It’s better to find and fix problems before that date so that your reimbursement is not delayed.

Because the transition from ICD-9 to ICD-10 is required, this is not something you can put off. Your third-party reimbursement depends on your practice being ready for this transition.

Reference

ICD-10: Quick Start Guide

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