How to Code Using ICD-10

The ICD-10-CM coding system will replace the current ICD-9-CM system on Oct. 1, 2013. ICD-10-CM is the World Health Organization's International Classification of Diseases, 10th Revision, Clinical Modification. Medical coders use ICD to translate the words used by physicians and other health care providers to describe a patient's condition into alphanumeric codes to transmit claims to insurance companies. ICD-10-CM rules and codes differ greatly from those of ICD-9-CM. The new code set intimidates many medical coders, since it contains more than five times as many codes as the previous one. Familiarize yourself with the new coding methods now, and you will feel secure on Oct. 1, 2013.

Things You'll Need

• ICD-10-CM Books

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Instructions

• 1

  Obtain ICD-10-CM books from one of numerous organizations or companies, such as the American Medical Association or Medical Arts Press, or search the Internet for online versions of the books. Three volumes comprise ICD-10-CM: Volume 1 - The Tabular List; Volume 2 - The Instruction Manual; and Volume 3 - The Alphabetical Index. You must use volumes one and three together to accurately code.

• 2

  Learn the many ways in which ICD-10-CM differs from ICD-9-CM. ICD-10-CM codes have three to seven characters. Every code begins with a letter; the alpha characters are not case-sensitive. A seventh character is required on some diagnoses that begin with "M," "O," "R," "S," "T," and "VWXY." The ICD-9-CM "V" codes will become "Z" codes, and "E" codes will change to "VWXY" codes.

• 3

  Visit the Centers for Medicare and Medicaid Services website to learn about General Equivalence Mappings (GEM). This tool eases the conversion from ICD-9-CM to ICD-10-CM. The mappings cross walk backward and forward between the two coding systems. They do no correlate one-to-one in most cases, though, since the new system is much more precise than the current one. Use the mappings to find a starting point to determine the correct ICD-10-CM code for each diagnosis, as a single ICD-9-CM code may translate to several different ICD-10-CM codes.

• 4

  Note that ICD-10-CM codes are very specific. Consider a wrist fracture. In ICD-9-CM, an unspecified fracture of the wrist is 841.00 -- Closed fracture of carpal bone unspecified. In ICD-10-CM, the closest approximation is S62.109A -- Fracture of unspecified carpal bone, unspecified wrist, initial encounter for closed fracture. Code more accurately by asking the provider which wrist was injured. If it was the right, the code would be S62.101A. The sixth digit, "1," denotes the right wrist. A "2" shows it is the left wrist, and "9" states the wrist was not specified. The final character, "A," indicates the visit was an initial encounter for a closed fracture.

• 5

  Bone up on your knowledge of anatomy. Doctors' notes will need to be very specific. Read the "ICD-10-CM Official Guidelines for Coding and Reporting" on the Centers for Disease Control and Prevention (CDC) website. Create a "cheat sheet" of your most-billed diagnosis codes by coding them in ICD-10-CM. Examine the quality of your providers' documentation. Set up and instigate plans to improve any weaknesses in their reporting.