New coding tool designed to help with ICD-10 transition

Worried about the transition from the International Classification of Diseases, Ninth Revision (ICD-9), to ICD-10? A new Web site is designed to ease the process for you and other healthcare providers by enabling you to input your currently used codes to find the appropriate new ones.

Physicians currently can memorize the ICD-9 codes they most frequently use in their practices, because they typically use only about 10 codes, says Andrew D. Boyd, MD, part of the team of researchers at the University of Illinois at Chicago (UIC) that developed the tool. "When you think of a specific disease, you literally think of the individual code," he adds. But that ability will change with ICD-10, which will see the overall number of codes increasing from 14,000 to 68,000.

The UIC team has identified the 36% of ICD-9-CM code mappings that have no straightforward correspondence in ICD-10-CM. For example, what was once coded as "ear infection, unspecified" may now be coded as "ear infection, left ear," "ear infection, right ear," "ear infection, both," or "ear infection, unspecified."

"We've tried to simplify these coding changes to the point where they can be understood and used," says Boyd, assistant professor in biomedical and health information sciences at UIC and first author of a published study about the Web site and related research.

The complex translations related to ICD-10 are organized into clusters of two or more somewhat related codes, explains Yves A. Lussier, MD, professor of medicine and engineering in medicine and principal investigator of the work. "Many ICD-9 clusters map to many ICD-10 codes, and many ICD-10 codes map back to a significantly different cluster of ICD-9 codes."

Boyd adds: "It's not one-to-one; it's not one-to-many, it's many-to-one. It's convoluted, it's entangled. When you map one ICD onto the other, it looks like a star map."

Healthcare providers have until October 2014 to switch to the new coding system, used to classify every disease or condition and in every aspect of healthcare from ordering supplies to insurance reimbursement. Precise coding will be more crucial than ever for documenting patient encounters, maximiizing timely reimbursement for services performed, tracking revenue, managing supplies, making staffing decisions, and other purposes.

The American Medical Association estimates that the administrative costs associated with ICD-10 implemention will be $87,000 to $2.7 million per practice, plus potential losses in reimbursement due to incorrect coding. The UIC reseachers, however, found that the transition could be more costly and disruptive to productivity than expected, so the tool was created in a manner that could allow practices to make the change without hiring outside experts.

The study results are available online in advance of print in the Journal of the American Medical Informatics Association.

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