Medical coders of the present and future need to become very familiar with the ICD-10-CM, which stands for International Classification of Diseases, Tenth Edition Clinical Modification. The CM distinction was added to note the improvement in this latest version of the system used to classify tens of thousands of conditions. The ICD-10-CM is a system of codes that comprises its own unique language. Medical coders and billers use these codes for billing and insurance purposes. It could be likened to the specific language used in health care.
Doctors, nurses and other health care professionals use these codes as a way of enhancing the way they store and retrieve diagnostic information. Health information managers also use these codes on a daily basis. The reason why the coding system has been changed to the ICD-10-CM is due to the advances in medicine, which adds constant innovation and discoveries. To compensate, a more detailed written language needs to exist.
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ICD-10-CM and ICD-9-CM Differences
The ICD-10-CM has a much higher level of specificity than its predecessor. For example, there were several instances when the ICD-9-CM only specified that a certain internal part of the body is diseased. The new system is more exact. Now, the ICD-10-CM can diagnose more specifically. The new system can diagnose parts of the ovary that are diseased, whereas the previous system simply diagnosed the entire ovary with disease.
This process has also caused the need for more detail to be included in medical documents. The precision allows for more sophisticated diagnoses, which means medical coders will also need to know more detail. Coders will also need to be aware of all the coding changes that occur at what seems to be a very rapid pace.
Each year, there are updates to the ICD-10-CM. In January of 2018, there were 363 new codes implemented, 142 codes deleted, and 226 code revisions, according to the AAPC (American Academy of Professional Coders). Staying current on these codes remains a top priority for all medical coders. However, that does not require reading through every single code as there are helpful hints to know which areas to examine.
Technology and ICD 10 Evolving
Technology is constantly changing both treatment and conditions. Pregnancy serves as an example with more widespread use of reproductive technology. So many couples are using these methods as a way of enhancing their chances of becoming pregnant, which leads to new complications that need describing. Such complications may now fall under the ICD-10-CM code of O00 which refers to an ectopic pregnancy. Pregnancy complications are now much different and unique, which has prompted such updates and changes.
The deletion of antiquated codes is a result of new identifications. This is reflective of more accurate forms of treatment and diagnosis. Furthermore, new codes have supplanted older codes which were labeled as missing. The ICD-10-CM contains some codes that never even existed and were represented by the ‘missing’ denomination.
Codes are recommended for changes every year with this system, although not every change is approved. In the fall of 2017, only about half of the proposed changes were approved in the ICD-10-CM. With so many changes and so many different codes, the entire process can be very overwhelming for novice coders. Nevertheless, there are ways to master this craft.
Importance of understanding Codes and Medical Terminology
It is important to know the most expeditious way to search for codes, which helps save time. For example, looking up a spontaneous rupture of flexor tendons would first require looking under
‘Diseases of the musculoskeletal system and connective tissue,’ which are coded M00 through M99. Then, there is a need to pinpoint the exact disorder. That would be ‘disorders of synovium and tendon’ and that falls under the code classifications that range from M65 to M67. A spontaneous rupture of synovium and tendon is labeled M66 and then add in the hand and you have a code of M66.34.
Ascertaining that information requires more than just memorizing codes, but also comes with an understanding of anatomy and medical terminology. The ICD-10-CM is becoming more and more complex and that makes the job of a medical coder more demanding. To help facilitate this process, there is a ICD-10-CM code manual and that is split up into three volumes: tabular index, alphabetic index, procedure codes that are reserved only for hospital use.
How ICD-10-CM is Also Affective
The ICD-10-CM was not created just to update new codes and toss out old ones. It makes for less work by decreasing the number of attachments that are needed to clarify the condition of a patient. The processing of claims has also been improved as payment systems now have a better design. Moreover, the administrative role of the entire health care system has been enhanced, while fraud and abuse have been on the decline. And now that the codes are more precise, it has become easier to monitor public health and its overall risks.