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What Are ICD-10 CM & ICD-10 PCS?

The International Classification of Diseases, or ICD, was originally developed for statistical analysis of the causes of death in different countries around the world. The ICD 9th edition, or ICD-9, was first used in the United States in 1979 to assign codes to inpatient medical procedures. Medical and technological advances in medicine have required the ICD-9 to be updated and modified to allow new codes to be added, leading to the ICD-10.

  1. ICD Codes

    • ICD codes are three to five or three to seven digits long, beginning with a number or letter. A decimal point is placed after the third digit. ICD codes have been split into two categories: ICD-CM (clinical modification) and ICD PCS (procedure coding system). Clinical modification codes are used by healthcare professionals in a variety of settings; however procedure codes are only used in the inpatient setting. The ICD-10 contains 68,065 clinical modification codes and 72,589 procedural codes, compared with the ICD-9, which had 14,025 clinical modification codes and 3,824 procedural codes.

    ICD-10

    • The ICD-10 classification system is used to collect data to improve healthcare services for areas including public health risk, resource utilization, health care delivery, health policy, research and clinical trials, prevention of health care fraud, quality and efficiency of care, strategic planning and administrative procedures. ICD-10 codes range from three to seven digits, with digits four through seven adding more specific information to the code.

    ICD-10 CM

    • ICD-10 clinical modification codes are used by healthcare providers in all settings except inpatient. The first three digits of the ICD-10/CM codes are similar to the corresponding ICD-9 code; however, the additional digits add clarification to the code. ICD-10/CM codes include post-surgical procedures and take into consideration the influences of socioeconomic factors that affect a patient's condition. The ICD-9/CM assigns one code to a procedure, such as a vascular graft, while the ICD-10/CM provides nine codes for the same procedure to account for complications that can occur.

    ICD-10 PCS

    • The ICD-10 procedural coding system is used to assign medical diagnoses in the inpatient setting only. ICD-10/PCS codes are seven digits in length, with the first three similar to the corresponding ICD-9 code. The digits that follow the decimal point, after the third digit, have specific meaning. For medical and surgical procedures, these digits represent the body system, operation, body part, surgical approach, surgical or medical device and qualifiers required for billing purposes. The ICD-10 PCS contains 16 different sections, including obstetrics, rehabilitation therapies, diagnostic imaging, nuclear medicine, radiation oncology and mental health.

    Implementation

    • Implementation of the ICD-10 as a replacement for the ICD-9 is occurring in phases. Healthcare educators were the first to be trained in this new system. Since August 2010, educators have been required to teach students both the ICD-9 and ICD-10 coding procedures. In August 2011, the ICD-10 will be used exclusively in bachelor's and associate's degree programs and coding certification courses beginning August 2012. All health care providers are required to comply with the ICD-10 coding procedures by October 2013.

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