ICD-10 FAQs
What's wrong with the ICD-9-CM diagnosis coding system?
ICD-9-CM was developed 30 years ago and it cannot accurately describe
diagnoses at the necessary level of detail needed for the management of
our healthcare system in the 21st century. In addition, a number of
countries have already moved to ICD-10. Therefore, the statistics
reported for diagnosis codes will be flawed since there is no compatible
data to compare internationally. We will be capturing morbidity data
using an outdated classification system, which can potentially cause
problems identifying and tracking new health threats (e.g., SARS,
anthrax).
Since the World Health Organization (WHO) is already working on
ICD-11, why don't we just implement ICD-11 instead of ICD-10?
No firm timeframes for the completion of ICD-11 developmental work or
testing have been identified, and no firm implementation date for
ICD-11 has been designated. This means the earliest projected date for
ICD-11 implementation would be 2020, assuming that no US clinical
modification is needed. Also, since ICD-11 will build upon ICD-10, many
of the costs and much of the work associated with upgrading to ICD-11
will be mitigated by ICD-10 implementation.
Is ICD-10-CM similar to ICD-9-CM diagnosis coding or is it completely different?
There are similarities between ICD-10-CM and ICD-9-CM diagnosis codes; however there are also distinct differences. The actual coding process remains the same.
| ICD-9-CM |
ICD-10-CM |
| 3-5 characters |
3-7 characters |
| First character is numeric or alpha (E or V) |
First character is alpha |
| Characters 2-5 are numeric |
Characters 2-7 are alpha or numeric |
| Always at least 3 characters |
Always at least 3 characters |
| Use of decimal after 3 characters |
Use of decimal after 3 characters |
ICD-10 Superbills: Example 1 Example 2
Why are there so many more codes in ICD-10-CM/PCS than in ICD-9-CM?
The increase in the number of codes allows for greater detail and flexibility. Added detail is important in tracking health care trends, analyzing quality issues, and evaluating outcomes for a variety of health care technologies and treatments.
ICD-10-CM/PCS has an improved structure, capacity, and flexibility for capturing advances in technology and medical knowledge. It incorporates greater clinical detail and level of specificity to provide better data for many purposes.
The greater number of codes doesn’t necessarily make it more complex to use, in fact the increase in codes makes it easier to find the right code. The Alphabetic index and electronic coding tools will continue to facilitate proper code selection.
Who maintains ICD-10-CM/PCS?
ICD-10-CM was developed and is maintained by National Center for Health Statistics (NCHS) under authorization by the World Health Organization (WHO).
ICD-10-PCS was developed and is maintained by Centers for Medicare and Medicaid Services.
Who needs education on ICD-10-CM/PCS?
The following may need some amount of education on the structure, benefits and changes seen in ICD-10-CM/PCS:
- Health information management staff responsible for health record servicesBilling or financial office professionals
- Accounting professionals
- Corporate compliance office staff
- Auditors and/or consultants who perform documentation or coding review
- Clinicians
- Clinical department managers
- Quality management staff
- Utilization management staff
- Patient access and registration staff (if they are involved in medical necessity determinations)
- Researchers
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- Ancillary department staff (e.g., physical therapists, occupational therapists, respiratory therapists)
- Visiting nurses
- Hospice professionals
- Nursing facility personnel
- Outpatient service billing personnel
- Data quality management staff
- Data security personnel
- Data analysts working both inside and outside the organization
- Other data users (e.g., performance improvement)
- Information technology and information systems personnel
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How many hours of intense coding training will be required?
As a result of the American Hospital Association/American Health Information Management Association (AHA/AHIMA) ICD-10-CM Field Testing Project, the conclusion was that a maximum of 16 hours of training may be sufficient for experienced coding professionals on ICD-10-CM. Physician practices may not need as much training due to the fact that they may utilize a limited number of codes. It is estimated that the ICD-10- PCS will likely require an additional 16-24 hours of training.
How long before implementation should intense coder training be provided?
According to the American Hospital Association/American Health Information Management Association (AHA/AHIMA) ICD-10-CM Field Testing Project, the majority of participants believed training should be provided 3-6 months prior to ICD-10-CM implementation as supported by the Field Testing Report.