Unusual Examples of ICD-10 Codes

Unusual Examples of ICD-10 Codes

Clinicians preparing and training for implementation of the ICD-10 code set have encountered some unusual results. In an effort to be more specific, eliminate waste, reduce fraud and save money, the ICD-10 codes are very specific, sometimes to the point of being humorous.

Practitioners can now provide coding that may leave insurance companies wondering about their clients and the activities in which they’ve been engaging. Every clinician remembers a strange or unique situation for which they’ve billed – and the difficulty they had explaining it to the patient’s insurance company. The following are some examples of the unusual and sometimes humorous coding available with ICD-10.

Members of the animal kingdom can be unpredictable, but ICD-10 coding points out just how unanticipated some situations can really be, from fast moving turtles to equine collisions. In the animal category, practitioners will find some interesting injuries to be noted and places where the event took place.

  • W59.22XA – Struck by a turtle
  • W611.2XS – Struck by a macaw, initial encounter
  • S30.867A – Anal insect bite, non-poisonous
  • V80.730A – Animal-rider injured in collision with a trolley
  • Y92.72 – Injury obtained in a chicken coop

All families have problems, but it seems that some clichéd situations are eternal. When families have problems, there’s a code for that.

  • Z63.1 – Problem with in-laws
  • Z62.891 – Sibling rivalry
  • W21.31XS – Struck with footwear
  • Z62.1 – Parental overprotection
  • Z73.4 – Inadequate social skills, not elsewhere classified
  • R46.1 – Bizarre personal appearance
  • G44.82 – Headache associated with sexual activity
  • R45.2 – Unhappiness
  • The arts can be dangerous and that’s amply demonstrated by ICD-10 codes that identify the supposedly safe venues in which to enjoy entertainment, but may not be as protected as individuals might think.
  • Y92.253 – Injured in an opera house
  • Y9250 – Injured at an art gallery
  • Y92.26 – Movie house or cinema
  • Y92.251 – Museum

Work-related accidents and injuries are a common complaint for medical professionals and the new codes reflect such injuries. It would appear that some individuals are at high risk of being injured is some unique ways, and some return for an encore performance.

  • V97.33XD – sucked into a jet engine, subsequent encounter
  • X52 – Prolonged stay in weightless environment
  • V95.41XA – Spacecraft crash injuring occupant
  • Z89.419 – Acquired absence of unspecified great toe

Leisure time activities account for a large portion of injuries. Sports-related injuries top the list, but there are some lesser known activities that can be just as dangerous. When it comes to leisure time activities, clients are presented with multiple opportunities for injuries.

  • V91.07XA – Burn due to water skis on fire
  • Y93.D1 – Stabbed while knitting or crocheting.
  • Y92.146 – Hurt at prison swimming pool
  • T63 – Unspecified event, undetermined intent (to be specific)

Some of the ICD-10 codes bring to mind weird and wacky laws that have outlived their usefulness, but have never been removed from the books. It bears remembering that while some codes were developed to address potential problems and injuries of the future as technology advances, many of the codes currently exist because a particular situation actually happened to someone, somewhere, sometime…

The 10 Advantages of ICD-10 Over ICD-9

The 10 Advantages of ICD-10 Over ICD-9

With the transition from the International Classification of Diseases (ICD)-9 to ICD-10 set to take effect on Oct. 1, 2014, it’s time to look at the advantages of ICDE-10 compared to the old system. ICD-10 provides 68,000 diagnostic codes and creates a new alpha-numeric system of 3-7 digits.

ICD-10 allows for different diagnosis coding according to the venue in which the patient is seen. ICD-10-C will be used by primary physicians and therapists, while ICD-10-PCS is for inpatient hospital procedures. Despite reticence and trepidation on the part of many clinicians, ICD-10 will provide some distinct advantages that will benefit practices in a variety of ways.

    1. The most important advantage to the new codes will be the ability to provide a more in-depth diagnosis for each patient and condition, ultimately leading to fewer claim rejections. Every practitioner has felt the frustration of having a reimbursement claim denied or sent back for more information. The new codes are designed to include a variety of expanded information to facilitate the claims process.
    2. The new coding system employs a new alpha-numeric sequence that allows for easy changes and updates as technology advances.
    3. ICD-10 codes are very specific about each incident in terms of when, where and how an injury took place, along with symptoms and any measures the patient may have taken on their own to gain relief. They provide numerous sub-categories for enhanced scope of reporting.
    4. The ICD-10 system provides clinicians with an updated listing that takes into account changes in technology and practices that have evolved since the implementation of ICD-9 over 30 years ago. New diseases, conditions and terminology allows for a better and broader scope of reporting ranging from animal attacks to conditions arising from space age technology.

  1. The enhanced coding provides detailed data for statistics gathering, analysis and research.
  2. ICD-10 codes allows for better monitoring to assess quality of care.
  3. The new codes should provide greater insight into each patient case and reduce the need for volumes of client records to be transmitted. Electronic transmission of data reduces the need for paper records, offering an environmentally-friendly solution. Practitioners can share standardized information electronically with other caregivers for better patient outcomes.
  4. The greater specificity of ICD-10 has the potential for yielding better reimbursement levels for clinicians. Practitioners can discover which procedures generate the best revenues and bill accordingly when it’s appropriate.
  5. The new coding is designed to increase efficiency within practices, allowing clinicians to better manage their available resources to reduce overall healthcare costs.
  6. The U.S. is the only country that hasn’t already transitions to the ICD-10 codes. A universally accepted standard of coding allows information to flow freely between healthcare professionals any country in the world. This is especially important in the control of contagious diseases and potential epidemics, but has other applications, too. It allows for better monitoring to assess quality of care.

The transition to ICD-10 codes will require clinicians to capture data in new ways, but will provide practitioners with an improved means of documenting the complaints and diseases of each patient. That ability has the potential to generate a significant increase in revenues.

ICD-10 Codes: Changes in Medical Coding

ICD-10 Codes: Changes in Medical Coding

ICD-10 codes represent the biggest change to medical billing and coding since the late 70’s. Nitin Chhoda explains why transitioning and implementing this new coding standard will determine the survival of your practice.

ICD-10 codes changesUnderstanding the ICD-9 and ICD-10 codes is important to getting the most from your medical billing.

Without the right medical billing and coding practices, health insurance companies will deny claim after claim.

But there is more to ICD-10 codes than meets the eye. This new coding standard is more than just a hassle you’ve got to go through to get paid.

International Classification of Diseases

The ICD in ICD-10 codes stands for International Classification of Diseases.

From the widest perspective, this codification of health management terms and practices can serve as a way to analyze the health of a population. Epidemics, mortality rates, and all kinds of statistics can be gathered if a common codification system exists.

The World Health Organization (WHO) and The International Health Terminology Standards Development Organization (IHTSDO) take decades to update the ICD, in an effort to better understand the health of populations around the world.

Because the ICD and ICD-10 codes system is what the world is using to identify diagnoses, the United States government also uses it to classify and communicate about medical diagnosis.

For example, medical diagnosis and inpatient procedure coding for Medicare and Medicaid services uses the ICD-9 and ICD-10 codes system for all claims. Any medical billing relating to those services must use the ICD-10 codes.

Transition Time

Right now is an exciting time for medical coding and billing. On October 1st, 2014, the United States will finally adopt the ICD-10 codes. The ICD-9 codes were adopted in 1977, and since then we have not updated our coding procedures.

And the ICD-10 codes were finalized and endorsed in May of 1990 by the Forty-third World Health Assembly. ICD-10 codes came into use starting from 1994 by many member states.

ICD-10 codes medical changesThat has been some push-back, however, because this isn’t going to be the only change the United States undertakes this decade. The ICD-11 codes are being classified already with an estimated finalization scheduled for 2015.

While it may be a few more years before ICD-11 codes are available for adoption, if the U.S. wants to be up to date, two switches will likely occur in the next ten years.

On the other hand, the switch to the ICD-10 codes may present enough of a modernization for now.

After all, the U.S. waited ten years to adopt the ICD-10 codes. And this change is going to be significant enough. The ICD-9 codes number around 13,600. The ICD-10 codes number over 144,000.

Medical Coding Evolves

While not everyone is excited about the change to the ICD-10 codes, there are medical coding professionals who look forward to a more precise system.

There are also plenty of medical professionals who rely on ICD data for research.

By updating to the ICD-10 PDF codes, the United States is joining much of the developed world in building a better resource for health studies within the country as well as worldwide. The complexity that is being introduced will be a challenge to adapt to at first. But overall, everyone will benefit from a more modern system of medical coding.

ICD-10 Codes: What Will Change About Medical Billing

ICD-10 Codes: What Will Change About Medical Billing

ICD-10 is coming soon and will replace the current ICD-9 terminology. Nitin Chhoda clarifies the changes that are coming in the world of medical coding and how to deal with the upcoming transition to ICD-10.

ICD-10 codesAs with any significant change in procedure, there is a portion of the medical billing and medical coding community that is in panic.

There are also many people who unaware of the extent of impact that the ICD-10 codes will have on them.

To clarify some of the commonly misunderstood aspects of this change, below are the facts about medical coding changes due to ICD-10 implementation codes.

Compliance and Flexibility

The compliance date for switching to ICD-10 codes is October 1, 2014. There have been rumors circulating that that date is somewhat flexible or that extensions will be granted either to individual practices or to everyone.

The compliance date is set and will not be changed. All health care providers must use ICD-10 codes by Oct 1, 2014.

Additionally, many people believe that compliance with ICD-10 codes requirements is only necessary if you are using electronic medical records and an EMR system. This is also an incorrect assumption. No matter whether you use electronic medical records or you are still doing all of your filing on paper, the ICD-10 codes will be required for all medical practices.

Too Many Numbers

Changing from a code system of about 13,600 codes in the ICD-9 to the ICD-10 codes which number over 144,000 sounds daunting. The exponential rise sounds overwhelming, and it should come as no surprise that medical coding professionals are worried that it will be too complex to be practical. There are also serious (and legitimate) concerns about the increase in documentation time, claiming this level of detail is unnecessary.

ICD-10 codes are structured to be more logical to use and the codes are more clinically accurate than the ICD-9 codes. Medical coding should be easier, not harder.

The structure itself is improved so that you will be searching through categories which contain more specific codes than the previous version. Of course, every change requires some learning and adjusting. But once medical coders settle into the new system, they may find they like it better than the previous system.

Introduction of Unnecessary Tests

One concern voiced by clinicians is that with a more complex and detailed set of ICD-10 codes, medically unnecessary tests will need to be taken with patients so that a diagnosis can be made and the correct code can be assigned.

Fortunately, this is not the case. Nothing about the ICD-10 codes should dictate what medical tests and procedures are prescribed for your patients. The ICD-10 codes are intended for documentation of what is found by the clinician.

ICD-10 codes in billingIf a diagnosis hasn’t been made, the code used will be dictated by the symptoms. The ICD-10 codes are more flexible in this way than the ICD-9 codes, and they still contain the non-specific codes that can be used when you cannot make a diagnosis.

Many medical professionals are nervous about the change to ICD-10 codes. Before you worry about what this change will mean for you and your practice, remember that the ICD-10 codes were designed by and for clinicians like yourself.

ICD-10 Codes: What Are They?

ICD-10 Codes: What Are They?

On October 1, 2014, ICD-10 codes will officially be implemented. Adjusting from old to new medical codes can be very frustrating without a physical therapy software to rely on.

Nitin Chhoda explains how switching to electronic medical records will make the transition simpler.

ICD-10 codesA lot has changed since the implementation of ICD-9 coding. New diseases have been discovered, a better understanding of old ailments is available, and advances in treatment have made the old codes obsolete.

Therapists have been struggling for years trying to code for treatments and services that didn’t quite fit the range of possibilities available through the new techniques and technology. That’s all changing with the switch to ICD-10 codes in October 2014.

New Coding Options

The good news is that several thousand new coding options will be introduced into the current system of 13,600, making it easier for practice owners to bill for new treatments and procedures.

While it opens up multiple opportunities for clinics, the number of new codes will wreak havoc with practices without electronic medical records. ICD-10 codes are the first coding update since 1977 and it’s going to take the medical field by storm.

The ICD-10 codes represent the 10th update of the International Statistical Classification of Diseases and Related Health Problems (ICD). It includes many codes not used in other countries.

While many therapists may never provide services to those from a foreign land, they must be aware of the differences in coding when dealing with insurance providers in other countries, along with modifications made by those sovereigns.

Greater Latitude

The upcoming changes in coding offers therapists greater latitude when submitting reimbursement claims and providing treatments. The deadline for implementation has been pushed back many times.

The most recent delay, from Oct. 1, 2013 to Oct. 1, 2014, was partly instituted to allow those in the medical field to establish an EMR in their practice to facilitate the use of the new codes.

ICD-10 codes are significantly different from the old codes, range from 3-7 digits in length, and are used for documenting a diagnosis. An EMR will make the transition significantly smoother, but will still require extensive planning and staff training.

To add another level of difficulty to the transition, before therapists could use the new coding, they had to implement HIPAA’s 5010 transaction standards. Claims for reimbursement that don’t use the ICD-10 codes after the deadline will be rejected.

Major Changes

ICD-10 codes definedThe changes in coding affect medical providers, impacts insurance companies, and how practice owners are reimbursed. The ICD-10 codes reflect changes in all facets of healthcare, from new diseases and vaccines to medications and treatments.

The changes provide therapists to code in greater detail and offer more specific details about each diagnosis. The coding allows therapists to provide new services and offers more opportunities to be paid, but clinic owners should expect the changes to be disruptive at first.

In a world of international travel where pandemics are a real concern, the new ICD-10 codes will assist health and medical authorities track contagious and potentially devastating diseases that include various types of flu, HIV and AIDS, along with cancers in all its many forms. They will assist organizations that include the World Health Organization and the Center for Disease Control.

The ICD-10 codes represent an update that’s long overdue.

The new coding allows for a greater range of diagnosis and will be required if therapists are to be reimbursed for their treatments and services.

The first ICD codes were developed by Jacques Bertillon in 1893 France and adopted by the U.S. in 1898.

Technology and medical knowledge has improved steadily throughout the centuries and the latest incarnation of the ICD codes provides therapists with the tools to manage patient care and the profitability of their practices more efficiently.

The ICD-10 Preparation Timeline for Your Practice

The ICD-10 Preparation Timeline for Your Practice

Back in 2013, many clinicians breathed a sigh of relief when the Department of Health and Human Services delayed implementation of ICD-10 codes until Oct. 1, 2014.

That deadline is almost upon us and now is the time to establish a timeline that provides sufficient time for software installation, staff training, system testing, and rectifying any difficulties that arise.

ICD-10 codesImpact Analysis

The first step is to review the ICD-10 codes to obtain an understanding of the changes, how the transition will impact the practice and affect systems already in place.

Practitioners will need to conduct a complete inventory of manual and electronic systems that will be used in conjunction with the new codes, as they will need to be upgraded.

The American Medical Association estimates this phase will take 3-6 months to complete.

Contact EMR, Billing Software and Clearing House Vendors

The installation and integration of new systems and/or upgrades takes time and it’s essential to work closely with vendors on costs, work completion dates and support should problems arise.

Look for a vendor that maintains responsibility for updates, support, tools and training to minimize costs and facilitate a speedy transition. This phase of the project should take 2-3 months.

Contact Others In The Network

Practitioners will need 2-3 months to contact billing services, clearinghouses and payers to determine when their systems will be operational and ascertain when testing between the systems can commence.

Inquire as to the necessity of a contract changes that might be required as a consequence of the transition.

Vendor Upgrades

The IT work necessary for a transition of this scope will take vendors 3-6 months and they must be ready to deliver the appropriate system upgrades in sufficient time for training and testing.

Other systems concerned with public health and quality reporting will need upgrading to comply with usage of the new codes.

Internal System Testing

Two to three months will be required to test the level of preparation of documentation, billing and coding systems to ascertain that they function as they’re supposed to.

A practice conducts many types of transactions each day and the system should be put through a thorough shake-down process for each.

Documentation Updates

Clinicians should be prepared to invest 2-3 months examining their forms for patient encounters, superbills, and other data collection documentation. Make changes where needed to ensure that all details are included. Templates may need to be modified. It is critical to have a customizable electronic medical records system that allows you to create and maintain your own clinical documentation templates.

Training Staff

Develop a training schedule for staff that ensures each member understands and has a working knowledge of the new codes, how they affect the practice, and compliance issues. It will take 2-3 months for this portion of the practice’s timeline.

External TestingICD-10 codes

Contact payers, clearinghouses and billing services to schedule and conduct testing with each entity to ensure the practice can send and receive from them.

This can be done over the course of 6-9 months, as each company completes its own updates and upgrades.

Oct. 1, 2014 – The Big Day

Implementation of ICD-10 codes goes into effect on this day. Any claims with a date of service after October 1, 2014 that don’t use the new codes will be rejected. Even if all systems are in place before Oct. 2014, the new codes can’t be used before the official implementation date.

ICD-10 codes will result in major changes in the way clinicians document their patients’ visits and submit reimbursements. Claims submitted with ICD-9 codes (with dates of service after October 1, 2014) will be rejected and practitioners won’t be paid. Clinicians who begin now can be fully ready when the changes go into effect.