Mapping of ICD-9 to ICD-10

Mapping of ICD-9 to ICD-10

One of the identified benefits for the United States' transition from ICD-9 to ICD-10 is because of the increased level of specificity offered by the ICD-10 code format. This specificity will benefit patients and doctors (by giving more detailed diagnosis and treatment information), payers (by more accurately defining services) and international organizations that monitor worldwide disease.
However, all of this increased specificity comes at a price—the codes are becoming more complex. In ICD-9-CM, codes are three to five digits. The first digit is either numeric or alpha (the letters E or V only) and all other digits are numeric.

In ICD-10-CM, however, codes can be up to seven digits. The first digit is always alpha (it can be any letter except U), the second digit is always numeric, and the remaining five digits can be any combination.

The following example shows an ICD-10-CM code for chronic gout due to renal impairment, left shoulder, without tophus.

The corresponding ICD-9-CM code would have been 274.02, which only indicates gouty arthropathy. As you can see, the ICD-10-CM code contains much more information.

Mapping

Some ICD-9-CM codes map easily to ICD-10 in a simple one-to-one conversion. For example, the ICD-9-CM code 733.6 (Tietze's Syndrome) maps directly to the ICD-10-CM code M94.0. (An exact map does not always mean the codes match in detail.)

Other codes will require additional information to map for possible solutions. For example, the ICD-9-CM code 649.51 (spotting complicating pregnancy) requires information about weeks in pregnancy to map. There are three options: O26.851 (spotting complicating pregnancy, first trimester), O26.852 (spotting complicating pregnancy, second trimester), and O26.853 (spotting complicating pregnancy, third trimester).

And some codes require significantly more specificity and map into many more ICD-10-CM code set selections. For example, the ICD-9-CM code 962.9 (poisoning by hormones and synthetic substitutes) has sixteen corresponding ICD-10-CM codes, requiring information about both the cause of the poisoning and the type of encounter.

In an extreme example, the ICD-9-CM code 733.82 (other disorders of bone and cartilage, nonunion of fracture) there are 2530 corresponding ICD-10-CM codes due to the degree of specificity required in ICD-10.

  

ALERT:        The fact is :      No true crosswalk' exists between ICD-9 and ICD-10

For help with understanding ICD-10 and converting codes, refer to our AccuChecker Online ICD-10 code conversion tool, see our ICD-9 to ICD-10

 

See Other Articles Regarding ICD-10 :         http://hppaccuchecker1.blogspot.com/

 

 

For more information on AccuChecker Online or our services:

sales@accuchecker.com

pesilverio@hppcorp.com

786-231-7585 or 1-877-938-9311

 

ICD-10: How to Avoid These 5 Costly Problems

ICD-10: How to Avoid These 5 Costly Problems

·         Unspecified Codes Cause a Slowdown

·         Computerized Order Entry

·         Denials Based on Medical Necessity

·         Cash Flow Stops Flowing

·         Clinicians Frustrated, at a Breaking Point 

Because ICD-10 is so much bigger than ICD-9, many of the codes selected by mapping will be unspecified ICD-10 codes. When patients are seen now, select a specific ICD-10 code. Some of this work could be done by coders and does not need to be done by the clinician. 

Drive out unspecified ICD-9 codes.

Pay special attention now to the coding denials you're getting for medical-necessity procedures or treatments. These will only increase after October 2015. Look at your payer's coverage policies for procedures and diagnostic tests that you perform or order.  

Current  payment methodologies require complete, accurate, and detailed coding in order to calculate appropriate reimbursement rates, determine coverage, and establish medical necessity.

Furthermore, with all the quality measures and data collection, it becomes quite clear that a classification system that provides greater coding accuracy and specificity was greatly needed.  ICD-10 is to provide and meet the goals required  with the quality indicators. 

Independent of your current  E H R System and/or the Practice Management System (PMS), providers will require all the support to capture, meet and comply with the current guidelines/regulations to receive payment. 

Since 1983 we have been helping physicians to operate practices as a business, over 500 Medicare and Medicaid audits have given us the knowledge to develop the AccuChecker Product Line.  ACK has met the previous challenges in the past and is equipped to meet  the new landscape in today’s healthcare: 

·         ICD-10

·         HEDIS

·         PQRS

·         VBM – Valued Base Modifiers 

Call us for more details.

 

For more information on AccuChecker Online or our services:

sales@accuchecker.com

pesilverio@hppcorp.com

786-231-7585 or 1-877-938-9311

 

Looming shift to more complex ICD-10 coding system

Looming shift to more complex ICD-10 coding system 

Mapping of ICD-9 to ICD-10

It makes sense that it would be somewhat difficult because if the two codes sets were a simple one-to-one map-and-compare there wouldn't be much point in going to a new system.  Whenever you go to a new coding system there are going to be challenges trying to compare data collected under the old system with data collected under the new system.

·         The fact is :      No true crosswalk' exists between ICD-9 and ICD-10

·         ICD-10 Transition Poses Problems for ICD-9 Translation

 The understanding  and  correct use of ICD-10 will avoid:

·         Claims Denial

·         CMS Penalties and/or Claim Reductions

·         Potential CMS Audits ( Medicare and Medicaid) 

New resource and guide is available today :     AccuChecker Online

 

For Details see  the following link:        http://accucheckerack.blogspot.com/

 

 

For more information on AccuChecker Online or our services:

sales@accuchecker.com

pesilverio@hppcorp.com

786-231-7585 or 1-877-938-9311

GEMs are not Accurate Translation Tools

GEMs are not Accurate Translation Tools

With the introduction of ICD-10 , the need to outsource the medical task has increased enormously as there is a shortage of coders or coders who are well equipped to deal with the codes.

The fact is :      No true crosswalk' exists between ICD-9 and ICD-10 

With AccuChecker Online  and our support staff,  physicians and coders can correctly code for ICD-10.  The new methodology with ICD-10 requires you to understand:

 

·         Code First

·         Exclusion 1

·         Exclusion 2

·         Inclusion  

It has already been determined that the GEM tools and/or mapping of ICD-9 to ICD-10 or ICD-10 to ICD-9 is NOT accurate. Furthermore, the mapping is very confusing when it comes to the clinical documentation. Avoid payment reductions, penalties or even a potential CMS audit. 

AccuChecker Online has you covered ! 

 

 

For more information on AccuChecker Online or our services:

sales@accuchecker.com

pesilverio@hppcorp.com

786-231-7585 or 1-877-938-9311

THE PROBLEM WITH ICD10 AFTER 10/1/2015

THE PROBLEM WITH ICD10 AFTER 10/1/2015

Our staff working with clients keeps finding ICD10 diagnoses improperly coded as UNSPECIFIED codes or incorrectly coded in the course of mapping from ICD9, a situation that takes place when the coder or the electronic medical system (EMR) used in the practice fails to follow the required steps defined in the ICD10 coding guidelines thus generating insufficient codes that require higher specificity. That is going to cost you a lot of money. 

CMS will enforce penalties and reductions in payments to healthcare providers that fail to code ICD10 diagnosis to the maximum level of specificity as we move into the Pay-for-Performance (P4P) alternative. 

Remember the audits from Medicare and Medicaid recovering millions of dollars from overpayments caused by UPCODING in the last 25 years? 

We remember our involvement representing physicians before Medicare and Medicaid in more than 500 audits.  We learned that over 95% of the audits took place due to ignorance from providers not knowing how to code the pertinent levels of service.  

Proud to tell you that we have the right tool for coding ICD10 – AccuChecker OnLine – it is fast and accurate!  

AccuChecker OnLine is an online Internet database application in the market since the year 2000 it contains ICD10, ICD9, Procedures, Medicare Fee Schedules and Coding techniques plus training and FREE ongoing support.

AccuChecker OnLine starts at $199 per year or about 55 cents per day! 

Here is another solutionICD10 coding - FREE Webinars to our users:

·         PEDIATRC WEBINAR - TUESDAY at 10am and 1pm

·         ADULTS WEBINAR – WEDENESDAY at 10am and 1pm

 

Call us for a FREE demonstration at 305-227-2383

 

FOR MORE INFORMATION

HPP Management Group, Corp.

5201 Blue Lagoon, Suite 800

Miami, FL 33126

Phone: (305) 227-2383

Email: pesilverio@hppcorp.com

Website: http://www.accuchecker.com

 

 

 

 

 

 

 

 

 

10 things you should know about ICD-10

10 things you should know about ICD-10

1. Increase in number of Codes and Specificity

2. ICD-10 has tens of thousands of more terms than ICD-9-CM. To use ICD-10 effectively coders must know:

3. Changes will impact all departments

4. Enormous healthcare-wide impact

5. First FULL replacement in 30 years

6. Complicated Mapping

7. Anticipated short-term consequences of implementation

8. Anticipated Long-Term Benefits

9. Extensive foundational Knowledge will be required

10. Training is Critical

ALERT******

It is important to understand that the Mapping of Diagnosis is COMPLICATED:

• No one-to-one mapping from ICD-9 to ICD-10
• There may be multiple one-to-one possibilities
• There may be multiple cluster possibilities, with each ICD-10-PCS code a complete procedure while ICD-9 may be a combination of codes

 

Most Mapping is being referenced to UNSPECIFIED Conditions. The first year of implementation, CMS has requested that NO penalties be applied. However, that will change. Providers will face payment reduction for using UNSPECIIFED conditions.

The solution to AVOID penalties is AccuChecker Online.

 

FOR MORE INFORMATION

HPP Management Group, Corp.

5201 Blue Lagoon, Suite 800

Miami, FL 33126

Phone: (305) 227-2383

Email: fcortes@hppcorp.com

Website: http://www.accuchecker.com

 

ICD-10 Medical Diagnosis Code Gives Americans 70000 Official Ways To Get Sick, Hurt or Die

ICD-10 Medical Diagnosis Code Gives Americans 70000 Official Ways To Get Sick, Hurt or Die

Specific Changes to Diagnosis Code Reporting: ICD-10-CM

How does the ICD-10-CM diagnosis code set differ from the ICD-9-CM?

• The code set has been expanded from five positions (first one alphanumeric, others numeric) to seven positions. The codes use alphanumeric characters in all positions, not just the first position as in ICD-9.
• As of the latest version, there are 68,000 existing codes, as opposed to the 13,000 in ICD-9.
• The new code set provides a significant increase in the specificity of the reporting, allowing more information to be conveyed in a code.
• The terminology has been modernized and has been made consistent throughout the code set.
• There are codes that are a combination of diagnoses and symptoms, so that fewer codes need to be reported to fully describe a condition.

No Clear Mapping Between ICD-9-CM and ICD-10-CM Code Sets

AccuChecker Online is your ONE source to navigate ICD-10 , PQRS, Coding, HEDIS and other quality measures.

PEDIATRIC PRACTICES WEBINAR - 10 AM TO 12:00 PM (EST) or 1:00 TO 3:00 PM (EST) – TUESDAY

ADULT PRACTICES WEBINAR - 10 AM TO 12:00 PM (EST) or 1:00 TO 3:00 PM (EST) – WEDNESDAY 

·         How to prepare your ICD10 Super Bill

·         Transition from ICD9 to ICD10 using AccuChecker OnLine

·         What to look in ICD10 from your EMR and Practice Management System

·         HEDIS and PQRS measures using ICD10

·         Performance Reports - VALUE BASE MODIFIER – the transition to Pay-for Performance  

WEBINARS LIMITED TO 25 ATTENDEES PER SESSION. Please call us for REGISTRATION 

                                                                                                             

FOR MORE INFORMATION

HPP Management Group, Corp.

5201 Blue Lagoon, Suite 800

Miami, FL 33126

Phone: (305) 227-2383

Email: fcortes@hppcorp.com

Website: http://www.accuchecker.com

ICD-10 Is Here

 

ICD-10 is here

 The change to ICD-10 allows you to capture more details about the health status of your patients and sets the stage for improved patient care and public health surveillance across our country. ICD-10 will help move the nation’s health care system to better, smarter care.

You may wonder when we’ll know how the transition is going. It will take a couple of weeks before we have the full picture of ICD-10 implementation because very few health care providers file claims on the same day a medical service is given. Most providers batch their claims and submit them every few days.

Even after submission, Medicare claims take several days to be processed, and Medicare – by law – must wait two weeks before issuing payment. Medicaid claims can take up to 30 days to be submitted and processed by states. Because of these timeframes, we expect to know more about the transition to ICD-10 after completion of a full billing cycle.

It’s important that you know help’s available if you have problems with ICD-10: 

For general ICD-10 information, we have many resources:

·         HPP Management Group, Corp – Healthcare Consultants

·         AccuChecker Online

·         Mapping of ICD-9 to ICD-10

 

FOR MORE INFORMATION

HPP Management Group, Corp.

5201 Blue Lagoon, Suite 800

Miami, FL 33126

Phone: (305) 227-2383

Email: pesilverio@hppcorp.com

Website: http://www.accuchecker.com