ICD-9 Coding Guidelines

ICD-9 coding refers to the medical coding process that is based on the International Classification of Diseases (ICD). ICD is an international publication that is put out by the World Health Organization (WHO). The ICD, which is revised approximately every 10 years, is a classification system that compiles mortality and disease data, which is gathered from doctor offices, and inpatient and outpatient records from all around the globe.

History

• The ICD-9 was originally published in 1977. The ninth edition of ICD was adopted by most countries with the exception of the United States. American officials believed that ICD-9 focused more on the acute diseases common in developing countries versus the chronic diseases seen in the American population. In 1988, Congress passed the Medicare Catastrophic Coverage Act. This law made it mandatory for ICD-9 to be used on Part-B of all Medicare claim forms. It was later repealed.

  Health agencies in the United States worked with the WHO to develop a version of ICD-9 called ICD-9-CM. ICD-9-CM was a collaborative effort on the part of the American Hospital Association (AHA), American Health Information Management Association (AHIMA), Centers for Medicare and Medicaid Services (CSM) and the National Center for Health Statistics (NCHS). It was implemented in 1995. ICD-9-CM is scheduled to be replaced in late 2013.

Significance

• ICD-9 coding guidelines refers to the coding and sequencing procedures that are applied to health care diagnoses, medical procedures and treatments by medical billers and coders. In the United States, ICD-9-CM coding guidelines are used in combination with Healthcare Common Procedure Coding System (HCPCS).

  HCPSC is the coding system required by Medicare. It is divided into two tiers: Level I HCPSC and Level II HCPSC. Level I uses the same codes as ICD-9. Level II codes were developed specifically for use by medical equipment vendors, medical suppliers and ambulance services firms to seek proper payment by Medicare for products and services provided.

Identification

• On of the keys to the guidelines for ICD-9 coding starts with the codes that are used for diagnosing a disease. There are 24 classifications that cover a range of diseases, injuries, poisons, signs and symptoms, such as respiratory diseases, circulatory diseases, mental disorders and infectious and parasitic diseases. Under each classification, there are hundreds of diseases, conditions and injuries.

  Each classification is assigned a three-digit code range. For example, the code range for "Infectious and Parasitic Diseases" is 001-139. "Diseases of the Nervous System and Sense Organs" has the code range of 320-389. Mental disorders are covered by 290-319.

Features

• Here is how ICD-9 coding would be applied to the category of "measles." This disease is a under the classification of "Infectious and Parasitic Diseases." The numerical "code range" for this classification is 001-139. The three-digit numeric code, within the code range that is assigned to measles is "055 Measles". Under the category of "measles" the diagnosis can be narrowed even further. The coder has the choice six or seven codes to describe the condition, such 055.1 Postmeasles pneumonia, 055.7 Measles with other specified complications or 055.8 Measles with unspecified complication.

  ICD-9 coding also pertains medical procedures. It is important that the coder understands medical terminology to locate a particular procedure. Procedures are divided into classifications that are assigned two-digit codes. An example would be "(81) Repair and plastic operations on joint structures". This specific operation would be assigned a three or four digit code, such as (81.82) Repair of recurrent dislocation of shoulder.

Considerations

• ICD-10, which was released in 1992, is the latest edition. While most countries have already implemented ICD-10, the United States is still using ICD-9-CM. CMS is responsible for overseeing the development and implementation of ICD-10-CM/PCS for use in America. The new medical code, which is composed of a seven-character alphanumeric code structure, is not expected to be implemented until sometime in October 2013.

  The new system will not only bring the United States in line with the rest of the world, but is expect to lead to more efficiency and effectiveness in the categories, such as quality measurement, public health, research, organizational monitoring and performance, and reimbursement.