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by Dr. Mike A. Meyer, August 30, 2012

I would like to tell you that ICD-10-CM/PCS is job security; however, this may not be true. The reality is that ICD-10-CM is a much more complex coding system. ICD-10-CM coding system has approximately 70,000 codes in it while the ICD-9-CM has slightly less than 14,000 codes (CDC, 2010). A larger coding system will come with more complex rules. More complex rules will mean higher skill levels in medical coding and billing, requiring more sophisticated medical billing software functionality. What this means is that physicians, coders, billers and their administrators have until mid-year 2014 to become expert for the October 1, 2014 implementation of ICD-10-CM (CDC, 2012). Failure to train and/or be trained in this new code set timely will negatively impact your bottom line.

This is not like the 2004 HIPAA patient privacy implementation. The HIPAA legislation was an expense. Failure to train timely and implement smoothly ICD-10-CM (all providers) and ICD-10-PCS (hospitals and facilities), will be a total disruption in revenue streams. This is a time when working closely with your medical billing software companies is your best survival strategy.

A statement that my wife and I, who are both educators, like to share with our healthcare students is, “Healthcare is a business and business is bottom line driven. The bottom line of healthcare is driven by the medical codes.”

Each week, I will provide you with an ICD-9-CM and corresponding ICD-10-CM coding challenge question. Post your answer or thoughtful responses. At the beginning of next week I will post the correct answer. Have fun!

#1: Challenge Question for ICD-9-CM to ICD-10-CM

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Resources: Action Timelines for ICD-10-CM Implementation

Centers for Disease Control and Prevention (CDC). (2010). Classification of diseases, functioning, and disability control. Retrieved from http://www.cdc.gov/nchs/icd.htm

CMS. (2012). Large Providers Implementation Timeline. Access at: http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10LargeProvidersTimeline.pdf

CMS. (2012). Small Providers Implementation Timeline. Access at: http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10SmallProvidersTimeline.pdf (loaded data that wasn’t readable)

CMS. (2012). Payers Implementation Timeline. Access at: http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10PayersTimeline.pdf

CMS. (2012). Vendors Implementation Timeline. Access at: http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10VendorsTimeline.pdf

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