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Please review the answers below to some FAQs pertaining to the ICD-10 coding system and click here to review CGI’s ICD-10 Reference Guide.


What is ICD-10?
ICD-10 is a diagnostic coding system implemented by the World Health Organization (WHO) in 1993 to replace ICD- 9. The system was developed by WHO in the 1970’s and is now used in almost every country in the world, except the United States. In the United States, ICD-10 usually refers to the U.S. clinical modification of ICD-10: ICD-10-CM. The code set is scheduled to replace ICD-9-CM, our current U.S. diagnostic code set, on October 1, 2015. Another designation, ICD-10-PCS, for “procedural coding system,” will also be adopted in the United States on Oct 1. ICD-10-PCS will replace Volume 3 of ICD-9-CM as the inpatient procedural coding system. The final rule stated CPT® would remain the coding system for physician services. Fun Fact: The United States healthcare community is transitioning from the usage of approximately 25,000 ICD-9 Codes to roughly 69,000 ICD-10 codes.

What happens if I do not transition to ICD-10 Codes?
ICD-10 is federally mandated. If claims are not filed with ICD-10 codes, claims will be rejected and you will not be paid. The only exceptions are Worker’s Compensation and Auto Liability claims, which may accept either ICD-9 or ICD-10; however they have said that they will be ICD-10 ready by October 1, 2015. Fun Fact: All referrals, authorizations, and any requested clinical documentation must contain the appropriate ICD-10 code as of October 1, 2015. CGI will be sending all referring physicians new requisition forms containing the most commonly used ICD-10 codes for all specimens sent to us after October 1, 2015. All medical records requests will also contain only ICD-10 codes for all specimens sent after October 1, 2015.

What are some of the benefits of ICD-10?
The ICD-10 transition will be jarring at first, but in the long run it will improve reporting, reduce costs, and increase efficiency. ICD-10 is much more relevant to today’s technology and is already used by most developed countries. Fun Fact: CGI prepared documentation templates to ensure that you’re charting is in compliance with ICD-10 coding and compliance standards.

ICD-10 seems so complicated. Do physicians really need to use all the codes in ICD-10?
No. Healthcare providers will not use all the codes in the classification system; rather they will use a subset of codes based on their practice. Physicians will only use the ICD-10-CM code set for diagnosis coding. The ICD-10-CM code set is like a dictionary that has thousands of words, but individuals use some words very commonly while other words are never used. Fun Fact: CGI has adopted some quick coding sheets and crosswalk materials to assist with your transition to ICD-10.

What type of training does my practice need and where do I find it?
ICD-10 training is typically organized into three categories. The type of training required by each member of your team depends upon their roles and responsibilities within the practice. Following are general guidelines to help you identify the type of training that is most suitable for each member of your practice:

  • Documentation training for physicians, nurse practitioners, physician assistants, and other staff who document in the patient medical record
  • Coding training for staff members who work with codes on a regular basis
  • Overview training for staff members engaged in management and/or administrative functions

The degree of training required can vary based upon:

  • Your specialty
  • The number and type of diagnosis codes you commonly use

There are several online and instructor lead ICD-10 training options available for physician practices. Check with your affiliated hospital systems, medical societies, payers, clearing houses, and associated professional organizations to see what types of training they have available. in compliance with ICD-10 coding and compliance standards.

 

Fun Fact: CGI has the resources to help you! We have conducted an AAPC consultation and evaluation to ensure we are ICD-10 compliant and ready for October 1, 2015. We want to extend our resources to you. Please see our ICD-10 Reference Guide for more information.