1. ICD-10-CM

2. What Do These Items Have In Common? Killer Bees 1984 Y2k Ice-Free Polar Cap by 2013 Code Ability Seminars ©2014

3. Predictions That Never Came True Code Ability Seminars ©2014

4. Killer Bees Expected to reach the U.S. in the 1980s, but delayed 10 years. "The Swarm": A huge swarm of deadly African bees spreads terror over American cities by killing thousands of people. Weekly Reader. By 2013, the number of deaths is minuscule. The Centers for Disease Control doesn’t find enough to make a separate category for killer-bee-related deaths. 2013: 1 death in Central Texas. Code Ability Seminars ©2014

5. 1984 Orwell’s vision of a post-atomic dictatorship in which every individual would be monitored ceaselessly by means of the telescreen. Code Ability Seminars ©2014

6. Y2k Predictions of a Y2K computer bug; it was to crash many computers, and malfunctions would cause major catastrophes worldwide and society would cease to function. Code Ability Seminars ©2014

7. Ice-Free Polar Cap in 2013 In 2007, British Broadcasting Corporation reported the Arctic would be ice-free in summer 2013, citing U.S. scientist Wieslaw Maslowski. (Naval Post Graduate School) Al Gore cited Maslowski's analysis in his acceptance speech at the Nobel Peace Prize ceremony in 2007. In summer 2013, the Arctic had 533,000 more square miles of ice than the same time in 2012 – a 29% increase. Code Ability Seminars ©2014

8. ICD-10 Predictions "The implementation of ICD-10 will be the most significant, costly event that we will experience" (J.Rumpakis, Review of Optometry 1/15/09) Code Ability Seminars ©2014

9. ICD-10 Predictions "To upgrade to ICD-10 will cost a small practice (3 docs) $83,290” (Nachimson Advisors) Code Ability Seminars ©2014

10. ICD-10 Predictions "The cost will be up to 10 times more than the $600 per physician that the U.S Dept. of Health & Human Services has assumed" (American Academy of Professional Coders) Code Ability Seminars ©2014

11. ICD-10 Predictions "The cost of switching to ICD-10 will be about $20" (Alan Homestead OD) Code Ability Seminars ©2014

12. What Is ICD-10-CM International Classification of Diseases, Tenth Revision, Clinical Modification General information: www.cdc.gov/nchs/icd/icd10cm.htm Code Ability Seminars ©2014

13. Who Created National Center for Health Statistics (under Centers for Disease Control and Prevention) developed & maintains ICD-10-CM Who created & owns CPT? Code Ability Seminars ©2014

14. Who Affected Everyone covered by HIPAA, including providers and payers who do not deal with Medicare claims. Claims submitted electronically to any payer. HIPAA = Health Insurance Portability and Accountability Act Code Ability Seminars ©2014

15. Why Better data for: – Measuring quality, safety, and efficacy of care – Designing payment systems & processing claims for payment – Conducting research, epidemiological studies, and clinical trials – Setting health policy – Operational & strategic planning & designing healthcare delivery systems – Monitoring resource utilization – Improving clinical, financial, and administrative performance – Preventing and detecting healthcare fraud and abuse – Tracking public health and risks Code Ability Seminars ©2014

16. Why In 2012, AMA advocated to halt of implementation of ICD-10. AMA CEO James Madara: the move will "create significant burdens on the practice of medicine with no direct benefit to individual patient care." What was the AOA position? Code Ability Seminars ©2014

17. When In 2009, Dept of Health and Human Services published regulation requiring replacement of ICD-9- CM with ICD-10-CM. Implementation Date: Oct 1, 2014 What does “Implementation Date” mean? Code Ability Seminars ©2014

18. When IMPORTANT Claims with Date Of Service before Oct 1, 2014 must use ICD-9. Claims with Date Of Service Oct 1, 2014 (or later) must use ICD-10. Claims for services provided before October 1, 2014 must use ICD-9 even if they are submitted after the compliance date. Code Ability Seminars ©2014

19. When "After the compliance date, ICD-9 codes will not be accepted and any transactions with ICD-9 codes will be rejected." American Medical Association False. Code Ability Seminars ©2014

20. ICD-9 vs. ICD-10 ICD-10 code can contain more than one diagnosis – called combination codes. Example: E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema Code Ability Seminars ©2014

21. ICD-9 vs. ICD-10 Combined diagnosis/symptom codes. More specificity (longer code) to identify etiology, anatomic site, severity. Laterality. 3 - 7 characters (ICD-9 = 3 to 5 characters). Code Ability Seminars ©2014

22. Examples Most eye codes start with “H” Code Ability Seminars ©2014

23. Examples 367.9 Unspecified disorder of refraction & accomodation comparable to H52.7 Unspecified disorder of refraction (no laterality) (myopia, hyperopia, astigmatism: all have laterality) Code Ability Seminars ©2014

24. Examples 365.00 Preglaucoma, unspecified comparable to H40.001 Preglaucoma, unspecified, right eye H40.002 Preglaucoma, unspecified, left eye H40.003 Preglaucoma, unspecified, bilateral H40.009 Preglaucoma, unspecified, unspecified eye (1 = right, 2 = left, 3 = bilateral) (9 is not "unspecified" as general rule) Code Ability Seminars ©2014

25. Examples 366.10 Senile cataract comparable to H25.9 Unspecified age-related cataract (no laterality) Code Ability Seminars ©2014

26. Examples 366.16 Nuclear sclerosis comparable to H25.10 Age-related nuclear cataract, unspecified eye H25.11 Age-related nuclear cataract, right eye H25.12 Age-related nuclear cataract, left eye H25.13 Age-related nuclear cataract, bilateral (1 = right, 2 = left, 3 = bilateral) (0 is not "unspecified" as general rule) Code Ability Seminars ©2014

27. Examples 362.51 Nonexudative senile macular degeneration, dry comparable to H35.31 Nonexudative age-related macular degeneration (no laterality) Code Ability Seminars ©2014

28. Examples Symptoms Code Ability Seminars ©2014

29. Examples 379.91 Pain in or around eye comparable to H57.10 Ocular pain, unspecified eye H57.11 Ocular pain, right eye H57.12 Ocular pain, left eye H57.13 Ocular pain, bilateral Code Ability Seminars ©2014

30. Examples 784.0 Headache comparable to R51 Headache (no laterality) (R = Symptoms, Signs, Abnormal Findings) Code Ability Seminars ©2014

31. Examples 250.00 Diabetes mellitus without mention of complication, type 2 or unspecified type, not stated as uncontrolled comparable to E13.9 Other specified diabetes mellitus without complications (E = Endocrine, nutritional, metabolic disease) Code Ability Seminars ©2014

32. Examples 250.50 Diabetes with opthalmic manifestations, type 2 or unspecified type, not stated as uncontrolled comparable to E13.8 Other diabetes mellitus with unspecified complications Code Ability Seminars ©2014

33. Examples 362.01 Background diabetic retinopathy comparable to E13.39 Other specified diabetes mellitus with other diabetic ophthalmic complication (many many choices) (was in eye section, now in diabetes section) Code Ability Seminars ©2014

34. Examples 918.1 Abrasion, cornea comparable to S05.00XA Injury of conjunctiva and corneal abrasion without foreign body, unspecified eye, initial encounter or S05.00XD Injury of conjunctiva and corneal abrasion without foreign body, unspecified eye, subsequent encounter Code Ability Seminars ©2014

35. Examples S = S = Injury, poisoning and certain other consequences of external causes ”5 th ” character: 0 = unspecified eye 1 = right eye 2 = left eye Code Ability Seminars ©2014

36. Examples “6 th ” character: X – space saver Code Ability Seminars ©2014

37. Examples “7 th ” character is to be added to S05 codes A - initial encounter D - subsequent encounter S – sequela Code Ability Seminars ©2014

38. Examples 930.0 Foreign body, cornea comparable to T15.00XA Foreign body in cornea, unspecified eye, initial encounter or T15.00XD Foreign body in cornea, unspecified eye, subsequent encounter Code Ability Seminars ©2014

39. Examples T = T = Injury, poisoning & certain other consequences of external causes ”5 th ” character: 0 = unspecified eye 1 = right eye 2 = left eye Code Ability Seminars ©2014

40. Examples “6 th ” character: X = space saver Code Ability Seminars ©2014

41. Examples “7 th ” character is to be added to T15 codes A - initial encounter D - subsequent encounter S – sequela Code Ability Seminars ©2014

42. Examples V58.69 Long term use of other medications comparable to Z79.899 Other long term drug therapy (Z = Factors influencing health status and contact with health services Code Ability Seminars ©2014

43. How To Find a Code Crosswalking with: General Equivalency Mappings (GEMs) Maps ICD-9 to ICD-10 & vice versa. Code Ability Seminars ©2014

44. How To Find a Code GEMs “attempt to find corresponding codes between the two code sets”. GEMs do not provide an exact crosswalk between codes. An exact one-to-one match of ICD-9 and ICD-10 codes cannot be made. Code Ability Seminars ©2014

45. How To Find a Code GEM: www.cdc.gov/nchs/icd/icd10cm.htm File w/ 2 columns Other sources: www.aapc.com/icd-10/codes Enter ICD-9 or ICD-10 code, it finds comparable code www.icd10data.com Alphabetical and numeric converter. Code Ability Seminars ©2014

46. How To Find a Code Or Code Ability Seminars ©2014

47. How To Find a Code Stat ICD-10 app Free $20 Alphabetical search Save frequently used codes Code Ability Seminars ©2014

48. How To Find a Code Create document w/commonly used ICD-9s Cross reference ICD-9’s w/ GEMs or AAPC website. Code Ability Seminars ©2014

49. Where To Get ICD-10-CM www.cdc.gov/nchs/icd/icd10cm.htmDownload ICD-10-CM PDF Format Code Ability Seminars ©2014