1-800-628-8980

 

About ICD-10

ICD-10 is the 10th revision of the World Health Organization’s International Classification of Diseases (ICD) coding system. The ICD-10-CM (Clinical Modification) codes are used to capture diagnoses in all healthcare settings, while ICD-10-PCS (Procedure Coding System) codes are used to capture procedures only in inpatient settings.

The ICD-10 code set replaced ICD-9 in the US on October 1, 2015. All medical practices will need to switch to ICD-10 by the deadline or they will no longer be able to obtain reimbursement for the care they provide to patients. Payers, clearinghouses, billing services, and all other entities covered by HIPAA will need to comply with ICD-10.

The deadline for the transition to ICD-10 has passed. ICD-10 is a monumental change with far-reaching and often overwhelming implications for therapists. We are proud to report with Turbo PT, our clients were able to minimize disruption to their practices.

Why Are We Moving to ICD-10?

Therapists and the medical world at large are constantly making new discoveries. However, there are no numbers available for these new diagnoses. That’s were ICD-10 comes in.

  • ICD-10 accommodates greater clinical detail, which allows for several benefits, such as:
  • More accurate claims processing and reimbursement
  • Better data to measure treatment outcomes and report on quality of care
  • Easier identification of patients for disease management programs
  • Improved analysis of disease patterns and tracking of public health outbreaks
  • ICD-9 is more than 30 years old and contains outdated terminology.
  • ICD-10 reflects current medical practice more closely.
  • The structure of ICD-9 codes limits how many new codes can be created and many ICD-9 categories are full.
  • 13,000 diagnosis codes
  • Codes have 3-5 digits
  • Codes are primarily numeric
  • 68,000 diagnosis codes
  • Codes have 3-7 digits
  • Codes are alphanumeric

How Does ICD-10 Differ from ICD-9?

The Key Changes to Clinical Documentation

ICD-10 requires a greater level of specificity in clinical documentation. Therapists will need to document with the required granularity in order to: (1) to ensure billing staff have the necessary details to code correctly; and (2) so the documentation supports the codes submitted.

Examples of extra detail required in ICD-10 include:

  • More specific anatomical and physiological information.
  • Severity: for example, Asthma is categorized as either mild intermittent, mild persistent, moderate persistent, or severe persistent.
  • Laterality: nearly 25% of the ICD-10 codes are the same except for specifying left or right.
  • Encounter Sequence: almost 25% of the ICD-10 codes are the same except for indicating initial encounter, subsequent encounter, or sequelae.

 

How Can My Practice Prepare?

The scope of this change and its many implications, particularly for documentation and coding, are undoubtedly intimidating. In fact, The eHealth Initiative (eHI) survey conducted in partnership with the American Health Information Management Association (AHIMA), found that of 271 providers responding, only 17% had completed all external testing, and 66% have not yet completed internal testing. A total of 19% stated that they have no plans to conduct end-to-end testing, and between 50% and 60% of respondents reported that they had not conducted ICD-10 testing with Medicaid (56%), private payers (54%), or other providers (59%).

To mitigate the impact of ICD-10 on your practice and related anxiety, it’s essential to start planning early for a successful rollout – including evaluating current resources (technology and staff), obtaining training for you and your team, and testing ICD-10 workflows proactively.

ICD-10 Implementation Update

June 6, 2015

For 12 months after ICD-10 implementation, Medicare will not deny practitioner claims billed under the Part B physician fee schedule, as long as the practitioner used a valid code from the right family. After the 12-month grace period, all claims will require a proper ICD-10 code.

Download the CMS\AMA FAQ Sheet for additional information.

How Turbo PT Helps Your Clinic Comply with ICD-10

Turbo PT actively worked to ensure that our clients were ready for the switch to ICD-10. The ability to successfully navigate the ICD-10 transition was a top priority for our clients and our company. Thus, well in advance of the deadline we completed currently relevant updates for our All-in-one Practice Management, Billing, and Electronic Health Record system.

ICD-10 Product Updates

Our ICD-10 product enhancements are in place and ready for use. Our clients are presently able to: prepare claims in compliance with ICD-10, submit ICD-10 claims to payers, exchange clinical data with other entities in ICD-10, and run analytics involving ICD-10 diagnosis codes.

Turbo PT’s Key ICD-10 Updates

  • Built-in search capability to simplify ICD-10 code selection during charge entry. In addition to searching directly within the ICD-10 code set, clients will have the option to search for the ICD-10 codes related to a given ICD-9 code.
  • New billing edits that will reflect appropriate code combinations under ICD-10.
  • Updates to EDI and HL7 formats to allow for delivery and receipt of ICD-10 codes
  • Addition of ICD-10 code set reporting capabilities.
  • Dual coding” capabilities: clients will retain the ability to submit ICD-9 codes to payers who are exempt from the ICD-10 mandate and do not make the switch.

Update Process

Our clients with active support will continue receiving ICD-10 updates through our regular product updates delivered automatically to your office.

Understanding ICD-10 Code Selection

A patient has a displaced, closed fracture of the greater trochanter of the right femur (S72.111). The following codes would be assigned for this case:

  • Patient seen in the ER, admitted, and surgery performed: S72.111A, Initial encounter for closed fracture
  • Admitted to long-term care for rehabilitation after hip replacement: S72.111D, Subsequent encounter for closed fracture with routine healing
  • Discharged from long-term care and home health to see for continued physical therapy: S72.111D, Subsequent encounter for closed fracture with routine healing
  • Patient visits hospital radiology department for X-ray: S72.111D, Subsequent encounter for closed fracture with routine healing
  • Patient to physician office for follow-up visit: S72.111D, Subsequent encounter for closed fracture with routine healing

ICD-10 Checklist Download

The ICD-10 deadline past on October 1, 2015. Clearinghouses cannot help you identify which ICD-10 codes to use. Because ICD-10 codes are more specific, and one ICD-9 code may have several corresponding ICD-10 codes, selecting the appropriate ICD-10 code requires medical knowledge and familiarity with the specific clinical event. You won't know this until billing gets rejected, this can have a catastrophic impact on your billing! Don’t put your practice at risk. Enter your email and evaluate your compliance with the ICD-10 transition by downloading and following Turbo PT’s ICD-10 checklist.

ICD-10 Checklist

Enter your email and download our ICD-10 Checklist.

 

As Featured In:

Seeing is Believing. Request a Demo.

Demo