CMSA Today - Issue 5, 2014 - (Page 18)

ICD-10 Ready or Not Here Comes ICD-10! BY JANET COULTER, RN, MSN, MS, CCM, AND TRACY SUTTON, CPC T he ICD-10 transition is coming! Are you ready? The International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) takes effect on October 1, 2015. The World Health Organization, which publishes the International Statistical Classification of Diseases (ICD) code set, defines diseases, signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease. ICD-10 is a major transformation in our health care system. This transformation will affect everyone in the health care field and will have a major impact on anyone who uses health care information that contains a diagnosis and/or procedure code. The World Health Organization (WHO) adopted ICD-10 in 1990. Most industrialized countries have adopted ICD-10 except the United States. The United States is the last country in the world with modern health care to adopt ICD-10 diagnosis codes. ICD-9 was originally published in 1977 and adopted by the United States in 1979. In 1990, the WHO updated its international version producing ICD-10. Other countries began adopting ICD-10 in 1994. The United States partially adopted ICD-10 in 1999 for mortality reporting. outcomes, resources used, allocation, and performance measurement. In contrast, ICD-10 code sets provide more specific data that better reflects current medical practice along with updated COMPARING ICD9 AND ICD10 ICD-9 code sets produced limited data about patients' medical conditions and hospital inpatient procedures. ICD-9 is 30 years old, has outdated terminology, and is inconsistent with current medical practice. The structure of ICD-9 limits the number of new codes that can be created. Many of the ICD-9 categories are full. Additionally, the ICD-9 code set limits characters to three-to-five; lacks clinical specificity such as accurate anatomical descriptions, differentiation of risk and severity, key parameters to differentiate disease manifestations, optimal claim reimbursement, and value-based purchasing methodologies; does not account for complexity and severity; and does not capture key details of patient conditions for recording and exchanging pertinent clinical information. Finally, ICD-9 has the inability to analyze information for health care utilization, effectiveness, changes in population disease patterns, costs and 18 CMSA TODAY Issue 5 * 2014 * DIGITAL disease classifications and ability to update and add new codes. ICD-10 also allows for more effective case management and better coordination of care, and provides more accurate information to support the development and implementation of important health care policies nationally and regionally. Additionally, ICD-10 more accurately reflects a patient's conditions and services, and provides more detailed data to better analyze disease patterns and track and respond to public health outbreaks. Finally, ICD-10 refines and improves operational capabilities and processes with detailed ICD-10 Effective October 1, 2015

Table of Contents for the Digital Edition of CMSA Today - Issue 5, 2014

President’s Letter
Association News
CMSA Corporate Partners
The Community-Based Care Transitions Program
Ready or Not
The Final Step: Remembering to Revitalize
Child and Adolescent Psychiatric Systems
Index of Advertisers

CMSA Today - Issue 5, 2014