Class # 4 "Diagnostic Coding (ICD-10)" 
 

Medical coding is the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. The diagnoses and procedure codes are taken from medical record documentation, such as transcription of physician's notes, laboratory and radiologic results, etc.

Medical coding uses standardized codes to diagnose the services rendered to a policyholder. Every possible injury and diagnosis is assigned a universal code that is readily understood by both healthcare providers and insurance companies so these parties are operating under the same umbrella of information. This process has become particularly useful, in terms of efficiency, ever since the claims process moved over to a largely digitized format.

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) is a system used by physicians and other healthcare providers to classify and code all diagnoses, symptoms and procedures recorded in conjunction with hospital care in the United States

ICD-10-CM contains a list of codes corresponding to diagnoses and procedures recorded in conjunction with hospital care in the United States. These codes may be entered onto a patient's electronic health record and used for diagnostic, billing and reporting purposes. Related information also classified and codified in the system includes symptoms, patient complaints, causes of injury, and mental disorders.

The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-10-CM) is the U.S. health system's adaptation of international ICD-10 standard list of six-character alphanumeric codes to describe diagnoses. Standardizing codes improves consistency among physicians in recording patient symptoms and diagnoses for the purposes of payer claims reimbursement and clinical research.

 

What are the ICD-10 codes?

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) is a system used by physicians and other healthcare providers to classify and code all diagnoses, symptoms and procedures recorded in conjunction with hospital care in the United States.

History of ICD Codes

The first international classification edition, known as the International List of Causes of Death, was adopted by the International Statistical Institute in 1893.  WHO was entrusted with the ICD at its creation in 1948 and published the 6th version, ICD-6, that incorporated morbidity for the first time. The WHO Nomenclature Regulations, adopted in 1967, stipulated that Member States use the most current ICD revision for mortality and morbidity statistics. The ICD has been revised and published in a series of editions to reflect advances in health and medical science over time. ICD-10 was endorsed in May 1990 by the Forty-third World Health Assembly. It is cited in more than 20,000 scientific articles and used by more than 100 countries around the world.

ICD purpose and uses

ICD is the foundation for the identification of health trends and statistics globally, and the international standard for reporting diseases and health conditions. It is the diagnostic classification standard for all clinical and research purposes. ICD defines the universe of diseases, disorders, injuries and other related health conditions, listed in a comprehensive, hierarchical fashion that allows for: 
- easy storage, retrieval and analysis of health information for evidenced-based decision-making;
- sharing and comparing health information between hospitals, regions, settings and countries; and
- data comparisons in the same location across different time periods.
Uses include monitoring of the incidence and prevalence of diseases, observing reimbursements and resource allocation trends, and keeping track of safety and quality guidelines. They also include the counting of deaths as well as diseases, injuries, symptoms, reasons for encounter, factors that influence health status, and external causes of disease.

What is ICD-10?

CD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification)

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) is a system used by physicians and other healthcare providers to classify and code all diagnoses, symptoms and procedures recorded in conjunction with hospital care in the United States.

Like its predecessor ICD-9-CM, ICD-10-CM is based upon the International Classification of Diseases, which is published by the World Health Organization (WHO) and which uses unique alphanumeric codes to identify known diseases and other health problems. According to WHO, physicians, coders, health information managers, nurses and other healthcare professionals also use ICD-10-CM to assist them in the storage and retrieval of diagnostic information. ICD records are also used in the compilation of national mortality and morbidity statistics.

The ICD-10-CM revision includes more than 68,000 diagnostic codes, compared to 13,000 in ICD-9-CM. In addition, ICD-10-CM codes include twice as many categories. ICD-10-CM diagnosis codes consist of three to seven digits, compared to the three to five digit system of ICD-9-CM. The increase in the amount and length of ICD-10-CM codes will allow for greater coding specificity.

Despite not being used in American hospitals, the ICD-10-CM code set has been revised yearly since 2003 to keep up with alterations made to ICD-10 by WHO. In preparation for ICD-10-CM implementation, a partial code freeze stopped the regular annual updates to ICD-10-CM codes in October 2011. Since then, there have been limited yearly changes made to the ICD-10-CM coding set with the normal updates scheduled to resume in 2016. 

All Health Insurance Portability and Accountability Act-covered entities must begin using ICD-10-CM codes by Oct. 1, 2015, as mandated by the U.S Department of Health and Human Services. The ICD-10-CM implementation deadline has been delayed several times. ICD-10-CM guidelines were initially set to replace ICD-9-CM on Oct. 1, 2013. Two separate year-long extensions to the ICD-10-CM implementation date pushed it back to 2015.

The structure of ICD-10-CM codes is as follows. The first character must be an alpha character, excluding "u." The second and third characters are numeric and characters four through seven can be a combination of numeric and alpha characters. The first three characters categorize the injury and the fourth through sixth characters describe in greater detail the cause, anatomical location and severity of an injury or illness. The seventh character is an extension digit and used to classify an initial, subsequent or sequela (late effect) treatment encounter.

 

Very Helpful:

Click here for a complete listing of ICD-10 Codes

Required Assignments:
Please view the videos below:

 

​Optional reading assignment:

(Understanding Health Insurance, by Green and Rowell. 10th Edition)

"Introduction to ICD bottom page 132

"Overview of ICD Codes" page 133-134

Recommended ICD-10 Book:

ICD-10-CM 2017 The Complete Official Codebook presents the complete code set 21 chapters within a tabular list of diseases and injuries.

 

The American Medical Association (AMA) is the premier national organization dedicated to shaping a healthier future for America by empowering the nation's physicians to provide safer, more efficient and higher quality care for patients andcom munities. For more than 50 years the AMA has used its knowledge and resources to author and publish books, data files and online resources that answer the needs of today's busy physicians and their staff. The AMA line includes titles on CPT(R), HCPCS and ICD-10 coding; reimbursement; practice management; impairment; and HIPAA, electronic health records and Meaningful Use.

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