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The ICD-10-PCS And Its Implementation

By Violet Solomon


The ICD-10 stands for international Classification of Diseases and other Related Health Problems, tenth revision. It is used to code diseases and signs, the related symptoms, all the abnormal findings and complaints, the social circumstances and the external causes of injury and diseases. The coding list is published and updated by World Health Organization (WHO) and is used in many other countries other than US. The ICD-10-PCS in particular means the International Classification of Disease 10 Procedure Coding System and consists of both numeric and alphabetical codes ranging from three to seven in total.

The first digit in the code is used to indicate the medical practice section which can be surgery, monitoring, measuring, administration or any other section. The next digits specify the body system, root operation, the body part, the approach used and devices used in that order. The last character (seventh) is used as a qualifying digit. The first three characters are usually so crucial and are stored in the ICD manual to help in reference.

For the purpose of reference, the first three digits are normally stored in ICD manual. A good example is a code with the first three characters as 0C0 is used to indicate a medical or surgical procedure for mouth or throat alteration. The ICD-10-PCS came as a replacement CPT code for in-patients and numbers up to 87,000 in total.

With the implementation of ICD-10 coding system, the hospitals are expected to have 87, 000 new codes for all in-patient procedure coding replacing the existing 8,660 CPT codes. The replacement however takes place for the in-patient procedures only. The new codes are not applicable for billing the radiologist components and out-patient services, procedures and studies. The implication is that identical procures are described by CPT codes for out-patients but with ICD-10 for in-patients.

The 10th Procedure Coding System is to be used for the in-patient services only. They will not be applicable when it comes to billing the radiologist components. The other significant area where they are not applicable is on the out-patient services. The implication is that a similar procedure performed on in-patient and out-patient is differently coded. For out-patients, CPT is used but ICD-10 is used for in-patients procedures.

Given that the targeted year of full transition (2014) is here with us, you ought to have taken all the necessary steps towards this transition. There are only three alternatives if you are a healthcare player; to upgrade or replace the entire billing management system, outsource your services or opt for retirement.

As an industry player, you have only three options of which only one is viable. You can choose to upgrade or completely change the billing management system, outsource the services or choose to retire before the transition date comes.

The last minute rush, expect confusion and delays as hospitals, clinics, surgery centers, insurance companies, the CMS, the State Medicaid and all other healthcare providers try to comply in October 1, 2014 should be avoided. There are concerns arising from the implementation of ICD-10-PCS such as the possibility of using detailed information from this code to exclude coverage by the government and private insurance.




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