Medical Billing and EMR Software by Medisoft, Lytec and Greenway User Forum ICD-10 Did ICD-10 effect diagnoses or also effected procedures also?

This topic contains 0 replies, has 1 voice, and was last updated by  Robert Gabriel 3 years, 11 months ago.

Viewing 1 post (of 1 total)
  • Author
    Posts
  • #42676

    Robert Gabriel
    Keymaster

    Both, ICD-10 is much more specific:
    • For diagnoses, there were 14,567 ICD-9-CM codes and 69,832 ICD-10-CM codes.
    • For procedures, there were 3,882 ICD-9-CM codes and 71,924 ICD-10-PCS codes (in the 2015 versions of ICD-9-CM, ICD-10-CM, and
    ICD-10-PCS).

    One ICD-9-CM diagnosis code is represented by multiple ICD-10-CM codes:
    • 82002 Fracture of midcervical section of femur, closed:
    From S72031A Displaced midcervical fracture of right femur, initial encounter for closed fracture; delayed healing; – From S72032A Displaced midcervical fracture of left femur, initial encounter for closed fracture and other codes from the GEMs.
    ™ One ICD-10-CM diagnosis code is represented by multiple ICD-9-CM codes:
    • E11341 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema: • To ICD-9 cluster:
    – 25050 – 36206 – 36207
    Diabetes with ophthalmic manifestations, type II or specified type, not stated as uncontrolled; Severe nonproliferative diabetic retinopathy;
    Diabetic macular edema;
    ™ A few ICD-10-CM codes have no predecessor ICD-9-CM codes:
    • T500x6A
    • T501x6A
    • T502x6A
    • T503x6A
    • T504x6A
    • And others found in the GEMs; and
    Underdosing of mineralocorticoids and their antagonists, initial encounter;
    Underdosing of loop [high-ceiling] diuretics, initial encounter;
    Underdosing of carbonic-anhydrase inhibitors, benzothiadiazides and other diuretics, initial encounter; Underdosing of electrolytic, caloric and water-balance agents, initial encounter;
    Underdosing of drugs affecting uric acid metabolism, initial encounter;
    ™ One ICD-9-CM procedure code is captured by multiple ICD-10-PCS codes: • 8659 Suture of Skin and Subcutaneous Tissue of Other Sites:
    – To 0JQ10ZZ
    – To 0JQ13ZZ
    – To 0JQ40ZZ
    – To 0JQ43ZZ
    – And others found in the GEMs.
    How are the GEMs files formatted?
    Below is an example from the ICD-10-CM diagnosis mapping:
    ™ ICD-10-CM Source system code is on the left side;
    ™ ICD-9-CM Target system code is in the middle; and
    ™ Flags are on the right:
    Repair Face Subcutaneous Tissue and Fascia, Open Approach;
    Repair Face Subcutaneous Tissue and Fascia, Percutaneous Approach;
    Repair Anterior Neck Subcutaneous Tissue and Fascia, Open Approach;
    Repair Anterior Neck Subcutaneous Tissue and Fascia, Percutaneous Approach;
    ICD-10-CM Source Code ICD-9-CM Target Code Flags
    T1500xA 9300 10111
    T1500xA E914 10112
    T1500xS 9085 10000

    ™ T1500xA Foreign body in cornea, unspecified eye, initial encounter: • To ICD-9 cluster:
    – 9300 Corneal foreign body;
    – E914 Foreign body accidentally entering eye and adnexa.

    ™ T1500xS Foreign body in cornea, unspecified eye, sequela: • To 9085 Late effect of foreign body in orifice.
    The flags are read as:
    ™ 1 = On; and
    ™0 = Off.
    There are three different flags:
    ™ “Approximate” is Flag 1, which is in column 1 of the flags:
    • 1 means the translation is an Approximate match:
    – The majority of alternatives are considered an Approximate match;
    • 0 means the translation is an Identical match: – Rare in the procedure GEMs;
    – More common in the diagnosis GEMs;
    • Example of diagnosis Approximate match (1), not Identical match: – T1500xA 9300 10111;
    – T1500xA E914 10112;
    – Each of these codes is an Approximate match;
    • Example of diagnosis Identical match (0):
    – 41411 I2542 00000;
    – ICD-9-CM code 414.11 is an Identical match to ICD-10-CM code I2542;
    ™ “No Map” is Flag 2, which is in column 2 of the flags:
    • 1 means there is no plausible translation for the source system code;
    • 0 means there is at least one plausible translation for the source system code;
    • Notice the NODX “No Description Found” entry instead of a code number in middle column:
    T500x6A NODX 11000 T500x6D NODX 11000 T500x6S NODX 11000
    – T500x6A
    – To NODX
    – T500x6D
    – To NODX
    Underdosing of mineralocorticoids and their antagonists, initial encounter: No description found.
    Underdosing of mineralocorticoids and their antagonists, subsequent encounter: No description found.

    – T500x6S Underdosing of mineralocorticoids and their antagonists, sequela:
    – To NODX No description found; and
    ™ “Combination” – Flag 3, which are the scenario and choice list flags:
    • 1 means code maps to more than one code;
    • 0 means the code maps to a single code;
    • Flags 4 and 5 further clarify combination entries (refer to the “Documentation and User’s Guides” for complete information on these flags):
    ICD-10-CM Source Code
    T1500xA T1500xA T1500xS
    ICD-9-CM Target Code
    9300 E914 9085
    Flags 10111 10112 10000
    – T1500xA Foreign body in cornea, unspecified eye, initial encounter: – To ICD-9 cluster (Flag 3 is 1):
    – 9300 Corneal foreign body;
    – E914 Foreign body accidentally entering eye and adnexa.
    – T1500xS Foreign body in cornea, unspecified eye, sequela (Flag 3 is 0): – To 9085 Late effect of foreign body in orifice.
    Is there a one-to-one match between ICD-9-CM and ICD-10?
    No, there is not a one-to-one match between ICD-9-CM and ICD-10, and the reasons for such include: ™ There are new concepts in ICD-10 that are not present in ICD-9-CM;
    ™ For a small number of codes, there is no matching code in the GEMs;
    ™ There may be multiple ICD-9-CM codes for a single ICD-10 code; and
    ™ There may be multiple ICD-10 codes for a single ICD-9-CM code.
    Are there instances when it is not necessary to use the GEMs?
    In the following instances, it may not be necessary to use the GEMs:
    ™ When a small number of ICD-9-CM codes are being converted to ICD-10-CM and ICD-10-PCS codes,
    it may be quicker, easier, and more accurate to simply look up the codes in an ICD-10-CM or
    ICD-10-PCS code book; and
    ™ When ICD-10-CM/PCS is implemented on October 1, 2015, coders will use coding books or encoder
    systems to code rather than using the GEMs.
    Sources of information: https://www.cms.gov/medicare/coding/icd10/downloads/gems-crosswalksbasicfaq.pdf

Viewing 1 post (of 1 total)

You must be logged in to reply to this topic.

START TYPING AND PRESS ENTER TO SEARCH