5 Major Changes Between ICD-9 and ICD-10 That Chiropractors Need to Know

SEATTLE - Dec. 18, 2013 - PRLog -- Many small physician practices such as chiropractors or dentists may be puzzled by the big push towards ICD-10.  After all, in their world, these doctors only tend to use a small fraction of the current ICD-9 diagnosis code set.  Regardless of whether it seems logical or not, ICD-10 is coming and small physician practices need to be prepared as  they may face the most difficulty in adapting.

There are several reasons behind the health care industry's transition from ICD-9 to ICD-10. The ICD-9 codes system is around 35 years old now and is thus outdated. It does not provide specific detailed data related to medical conditions and hospital procedures. The numeric structure of the ICD-9 codes puts a cap to the number of new codes that need to be created, as per the changes that take place.

On the other hand, the ICD-10 codes add specificity and are precise in a patient's diagnosis and procedure description. ICD-10 will yield to accurate, efficient and streamlined billing as well as methods of detecting fraud. The transition to ICD-10 codes will require investing time for planning, specification training, system and software upgrades, etc.

The five significant changes between ICD-9 and ICD-10 that chiropractors need to know:

1.       Use of Alphabetic Codes

ICD-10 codes are structured using alphabets (not case sensitive) whereas the ICD-9 codes are totally numeric codes. This will enable creation of new codes related to specific procedures and diagnosis in the ICD-10 coded system.

2.       Representation and Length of Code

The ICD-9 codes are usually 3-5 digits and consist of numeric characters whereas ICD-10 CM and ICD-10 PCS codes are 3-7 digits and consists of alphanumeric characters. The alphabets I and O are not used to avoid confusion.

         ICD-10 codes follow a standard format and structure, and thus are relatively longer than ICD-9   codes.

·      Digit 1 is an alphabet

·      Digits 1-3 represent the category

·      Digits 2 & 3 are numeric

·      Digits 4-6 refer to clinical details and can be alphanumeric

·      Digit 7 is a supplemental extension and can be alphanumeric

         The addition of characters is to allow detailed information to accurately describe the patient’s condition: for example listing a specific body part, right side or left side.

3.  Number of Codes

According to the U.S Department of Health and Human Sciences, ICD-9 codes are a total of 17,000 including the Diagnosis codes (13,000) as well as Procedure based codes (4,000), but have a limitation of new codes that can be created. ICD-10 will provide more information as it has approximately 68,000 diagnostic codes available as well as around 72,000 codes related to procedures. There is a possibility for adding on new codes to the ICD-10 in contrast to ICD-9 codes.

4. Combination Codes

ICD-10 codes are combination codes and thus are used to represent multiple diagnoses as well as several complicated diagnoses. The ICD-9 codes had to be supported by other additional codes to be able to denote the specifications in a procedure. The ICD-10 codes are structured to denote the specific information in one code, thus reducing the number of codes used.

         5. Relevance to Modern Technology

ICD-9 is a system dated back to the 1970's. With all the modern technological advancement in the field of Medical Sciences, the system used by physicians, for billing purposes and for keeping a record or track of patients and their health related problems, had to be upgraded too. ICD-10 is up to date with the latest technology, and the codes specifically represent the devices and equipment being used for procedures. There is provision for addition of more codes in the future so that the new codes are added as new technology or procedural advancements take place.

ICD-10 is a total change in structure of ICD coding system. The changes are very significant, and chiropractors need to be more thoroughly trained to be able to deal with the increased level of complexity.

Before you panic.  “ICD-10 is not all bad news!” states certified professional coder and chiropractor, Dr. Tom Necela of The Strategic Chiropractor consulting firm.  “Given its increased specificity, chiropractors will have better opportunities to get more information on their claim form.  This can lead to faster reimbursements and fewer requests for chart notes.  This should please most any doctor – less paperwork and faster pay!”

Finally, Dr. Necela advises  that chiropractic offices allow at least 3-6 months to fully train and implement the new ICD-10 system in the chiropractic setting.