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ICD-10-CM: The Next Generation of Coding

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Welcome to ICD-10

After nearly 30 years, a new era of coding for diagnoses is coming. The International Classification of Diseases, Ninth Revision, Clinical Modification, or ICD-9, is running out of codes to manage the hundreds of new diagnosis codes that are submitted by specialty societies and quality monitoring agencies. The new set of codes identified as ICD-10 was approved by the Department of Health and Human Services and has greater specificity and epidemiological tracking for disease management with over 68,000 codes in its system. Presently, there are approximately 14,000 ICD-9 codes available.

ICD-10 diagnosis codes will become effective on October 1, 2015. This is a single go live date for all providers, hospitals, payers and healthcare vendors. The Centers for Medicare and Medicaid Services administrator Marilyn Tavenner has indicated that the Agency intends to hold firm on the go live date and there will be no delays.

Training Rheumatology Experts in ICD-10

Program Information
The American College of Rheumatology has developed a one day training workshop on rheumatology specific coding for ICD-10. These hands-on, interactive, full day workshops focus exclusively on the evaluation and treatment of rheumatology diseases and conditions. Instructors will guide attendees to accurately and speedily choose an appropriate ICD-10-CM code(s) for the associated medical record using a variety of tools. 
This dynamic training program teaches rheumatology coding professionals how to become proficient in the ICD-10-CM coding system. In this course, attendees will learn about the history, structure, format of ICD-10-CM as well as how ICD-10-CM compares to ICD-9-CM. In addition, providers and their staff will learn how to apply the new coding conventions and guidelines to musculoskeletal and connective tissue diagnostic code assignment. There will be hands on instructions how to extract the diagnosis codes from the medical records with step-by-step training on using the ICD-10-CM manual.  
The goal of the ACR's coding and billing workshop series is to equip rheumatologists and their staff with the necessary tools to achieve coding compliance and attain optimal reimbursement while preventing fraud and abuse.

The workshop includes:

  • Review of key guidelines and conventions to work with the new system
  • Identify characteristics and detail information on the new expanded codes
  • Documentation requirements and reporting hierarchy for conditions and diagnoses
  • Coding structure differences, including use of extensions
  • Evaluation of the ICD-10 section and chapter overview for musculoskeletal and connective tissue
  • Overview  of basic medical terminology and anatomy
  • Analysis of differences in ICD-9 vs. ICD-10
  • ICD-10 Cases Studies
  • ICD-10 Assessment Test

Fees include the ACR course study guide only. See course requirements to order ICD-10 manual.

Applicant Type Full day Workshop (M-F) Full day Workshop (Week-end) Half-day Workshop
ACR Member $400 $499 $200
ARHP Member $400 $499 $200
Non Member $450 $550 $250

Registration Form

** Click here to register for the ICD-10 coding workshop in Chicago during the SOTA meeting    

Course Requirements

Due to the fast paced and hands on nature of the course, it is recommended that participants bring an ICD-10 book to participate in the course.

To order the manuals, visit the AMA Bookstore or Amazon.

Structural Differences between the Two Coding Systems

The Musculoskeletal System in ICD-10

The musculoskeletal system is found within Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99). This system comprises of the muscular and skeletal system.

There are several changes and expansion to the musculoskeletal code system in ICD-10. Most codes in this section require additional documentation that is required to correctly code site and laterality to the highest level of specificity. Which include:

  • documentation of site and laterality
  • more specific information for fractures and injuries
  • identification of episode of care
  • additional coding instructions surrounding osteoporosis
  • reorganization of codes

In ICD-10 there is greater detail to identify and report a diagnosis more appropriately. Some categories and subcategories in the musculoskeletal system (Chapter 13) require the use of seventh character extension - for example, 274.03 Chronic gouty arthropathy with tophus will translate to:

  • M1a.00x1 Idiopathic chronic gout unspecified site with tophus tophi
  • M1a.08x1 Idiopathic chronic gout vertebrae with tophus tophi

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Implementing ICD-10

The first steps that a practice should take are assessing the impact on the practice including a system inventory. Switching to ICD-10-CM will affect the practice management system and electronic health record and/or any other billing systems.

Physician practices should not have to implement new technology to use ICD-10-CM, however new encoding software may be needed to meet the requirements of the new code set to improve accuracy of coding.

Early preparation is vital to survival in rheumatology practices. Using a phased approach with a preparation checklist has proven to be the key to success in countries where ICD-10 is currently in use as it allows for resource allocation over a number of years, rather than all at once. Listed below are key areas that should be taken into consideration:

  • organize an implementation effort
  • develop a communication plan
  • conduct an impact analysis
  • estimate a budget cost analysis
  • contact system vendors
  • education and training for staff

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