ALERT ICD-10 Timeline Message
NCHIMA will NOT be making a statement or any comment on the ICD-10 timeline as this national and unified message will come directly from AHIMA in the near future- depending on the outcome of AHIMA's current talks with CMS and other decision makers. CMS does NOT hold the final word/decision in regard to the ICD-10 implementation timeline in the country- so there is still much talk ongoing. Please watch the AHIMA website under News/Alerts of the main page for any comment in regard to ICD-10.

ICD-10-CM/PCS Basic Facts:
• International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) is a clinical modification of the World Health Organization’s (WHO) ICD-10.

• ICD-10-CM includes the detail needed for morbidity classification and diagnostic specificity in the United States

• ICD-10-PCS is the Procedural Coding System. This is a much more robust volume of procedure codes than appeared in ICD-9-CM. It includes a seven character alphanumeric code structure.

• ICD-9-CM has 13,000 diagnosis codes and ICD-10-CM has 69,000

• ICD-9-CM has 3,000 procedure codes and ICD-10-CM has 87,000

• ICD-10 codes must be used on all HIPAA transactions, including outpatient claims with dates of service, and inpatient claims with dates of discharge on after October 1, 2013.

• Without ICD-10 codes claims may be rejected. CMS has noted that the compliance date will not be changed.

• CPT codes will continue to be used for outpatient services.

• Greater specificity required by ICD-10-CM will require improved clinical documentation

Benefits of ICD-10-CM:
• Greater coding accuracy and specificity

• Better information to measure healthcare service, quality, safety, and efficiency

• Reduced coding errors

• Greater achievement of benefits of an EMR

• Alignment of US with coding systems worldwide

• Enhances ability to track and respond to international public health threats

Impact of ICD-10 Conversion on Reimbursement:
• Anticipate delays for claims submission and payment until payer and provider personnel are trained and familiar with code sets

• Plan for a 20% decrease in coder productivity

• Will have to manage dual systems in the short term after the conversion to manage transactions that occurred prior to implementation of new code sets

• Increased staffing required to manage transition

• Claims denials may increase due to coding, reporting and processing errors

Training:
• Coding professionals should estimate between 16 – 50 hours of training depending upon experience

• Clinical documentation specialists should expect changes to documentation strategies

• Physicians will need training to understand how the transition will impact documentation opportunities

• Other healthcare professionals who may need education include: nurses, therapists, quality professionals, utilization review, researchers, data analysts