1. Don’t Be Afraid of ICD-10 Melonie Loutsch, CPC, ACS-EM April 26 th 2014

2. ICD-10 Delay A one-year delay of ICD-10 has been implemented. New target date for ICD-10 is October 1, 2015 Second time congress has acted to delay ICD- 10.

3. The start of ICD The classification system started in 1850 and was known as the International list of cause of death. 1883 the classification system was know as International Statistical Institute. 1948 the World Health Organization (WHO) took over the responsibility for this classification system better known as ICD (International Classification of Disease).

4. Why Convert to ICD-10 Now? ICD-9 has been around since 1978. 1990 the WHO endorsed ICD-10 to the world and many countries adopted it but the United States. Because of the age of ICD-9 it doesn’t accurately reflect all the advances in medical technology and medical knowledge.

5. Why Convert to ICD-10 Now ICD-9 is simply running out of codes with no room for expansion within the current 17 chapters. ICD-9 is also lacking the increased specificity that ICD-10 has.

6. ICD-10 Specificity With ICD-10 having higher specificity of codes it is believed that with more specific data – I10 will provider better information to identify diagnosis trends. – I10 will provider better information for public health needs. – I10 will provider better information to understand epidemic outbreaks. – I10 will provider better information on how to deal with bioterrorism events.

7. ICD-10 Specificity With I10 having more precise codes we will have – The potential benefit for fewer rejected claims. – Improved benchmarking data. – Improved quality and care management. – Improved public health reporting.

8. Grieving Process of ICD-10 Denial Stage – This can’t be happening Anger Stage – It is not fair what is the government thinking. Bargaining Stage – “Dear Lord if I10 doesn’t happen I will never complain about work again”. Depression Stage – I am never going to be able to learn this. I’m to old for this. Acceptance Stage – I learned ICD-9 I can learn ICD-10. It is going to be ok.

9. ICD-10 Not a Simple Update ICD-10 is not a simple update to ICD-9 but a whole fundamental change in the structure and concepts that make ICD-10 very different from ICD-9

10. Comparison Table

11. ICD-10 Chapters Chapter 1 - Infectious and Parasitic Disease Chapter 2 - Neoplasms Chapter 3 – Disease of Blood Chapter 4 – Endocrine and Nutritional Disease Chapter 5 – Mental Disorders Chapter 6 - Disease of Nervous Systems Chapter 7 – Disease of Eye and Adnexa (new)

12. ICD-10 Chapters Chapter 8 - Disease of Ear and Mastoid (new) Chapter 9 – Diseases of Circulatory System Chapter 10 – Disease of Respiratory System Chapter 11- Disease of the Digestive System Chapter 12 – Disease of Skin Chapter 13- Disease of Musculoskeletal System

13. ICD-10 Chapters Chapter 14 – Disease of Genitourinary System Chapter 15 – Pregnancy and Childbirth Chapter 16 – Perinatal Period Chapter 17 – Congenital and Malformations Chapter 18 – Symptoms, Signs, and Abnormal Clinical laboratory findings.

14. ICD-10 Chapters Chapter 19 – External Causes of Injury and Poisoning Chapter 20 – External Causes of Morbidity Chapter 21 – Factors Influencing Health Status and Contact with Health Services.

15. ICD-10 Code Structure Characters 1-3 – Category Codes Characters 4-6 – Etiology, anatomic site, severity, or other clinical detail. Character 7 - Extension

16. Code Structure

17. Documentation Readiness for ICD-10 Specificity- In ICD-10 they type of tobacco product being used is part of of the code choice selection and documentation should include this Clinical Support Documentation – BMI is coded secondarily to obesity and documentation needs to include BMI for proper code choice selection

18. Be Ready for ICD-10 Combination Codes – Diabetes Mellitus codes are now combination codes that include manifestations requiring documentation of any manifestation as well as the type of DM. Insulin Use – Long term use of insulin is coded for any Type 2 diabetic patient on insulin. Simplification – Immunization coding is simplified to 1 code.

19. Be Ready for ICD-10 Type – Documentation for upper respiratory infections needs to include acute, chronic, due to streptococcal or viral NOS in order to assign the most appropriate code. Cause – ICD-10 Obesity is classified due to drug, excess calories, and then further divided by morbid and sever.

20. What do Provider need to do Think in ink Let your documentation show what you are treating, managing, or reviewing Put it all in ink so that we can code to the highest specificity.

21. Team Work More now than any other time the medical tem must work together. Clinic, hospital, or nursing home With the move from ICD-9 to ICD-10, Meaning full use, and the ACOS. We need team work to encourage each other.

22. Don’t be afraid ICD-10 Instead of being afraid of ICD-10 we need to embrace it and forge ahead. It is the same as trying to eat an elephant. Just take one bit at a time.