CMS releases new ICD-10 fact sheet

The Centers for Medicare and Medicaid Services have released a new fact sheet outlining the World Health Organization’s International Classification of Diseases, 10th edition, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS).

ICD-10 has been in development since 1983, and was completed in 1992. A number of countries have already begun using ICD-10. Implementation of ICD-10 coding in U.S. healthcare organizations is mandated for Oct. 1, 2013.

The current system, ICD-9-CM, is 30 years old. According to CMS, it is outdated and obsolete and inconsistent with current medical practice. ICD-10, used by hospitals and physicians for disease classification and billing, represents significant improvements by using more detailed information and capturing advancements in clinical medicine.

ICD-10-CM/PCS consists of two parts. ICD-10-CM is the diagnosis classification system developed by the Centers for Disease Control and Prevention (CDC) for use in all U.S. healthcare settings. ICD-10-PCS is the procedure classification system developed by CMS for use in inpatient hospital settings only.

According to the fact sheet, diagnosis coding under the ICD-10-CM is similar to ICD-9 but will use seven alpha or numeric digits, whereas the ICD-9-CM coding system uses three or four numeric digits.

CMS says that ICD-10-CM/PCS incorporates much greater specificity, which will improve the ability to measure healthcare services, increase sensitivity when refining grouping and reimbursement methodologies, enhance the ability to conduct public health surveillance; and decrease the need to include supporting documentation with claims.

The codes will allow comparison of mortality and morbidity data and will provide better data for measuring care, designing payments systems, processing claims, making clinical decisions, tracking public health, identifying fraud and abuse, and conducting research.

CMS says organizations can plan for ICD-10-CM/PCS implementation by developing a plan that includes identifying stakeholders, formulating strategies and goals, developing education and training on all levels, developing an IT-system-change plan, and planning for documentation changes. Healthcare facilities will also need to plan on how to acquire resources and evaluate the financial effect the change will have on the organization.

ICD-10-CM/PCS will not affect physician, outpatient facility, or hospital outpatient department use of Current Procedural Terminology codes on Medicare fee-for-service claims since CPT will continue to be used.