Is Your Practice Ready for ICD-10?
Christopher Y Kim, MD, MBA, FASGE
Kathleen A Mueller, RN, CPC, CGCS, CCS-P, CMSCS, PCS, CCC
November 2013
The current version of diagnosis codes used in the United States since 1979 is formally known as the
International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) Volumes 1
and 2. Volume 3 is also used in Hospitals to record inpatient procedures. The ICD was developed by the
World Health Organization (WHO) and is maintained in the US by the National Center for Health and
Vital Statistics (NCHS), with the Centers for Disease Prevention and Control (CDC), under the US
Department of Health and Human Services (HHS).
The Tenth Revision of ICD, also known as ICD-10-CM, will debut on October 1, 2014. Essentially
overnight, the new codes will be required on services from that date going forward, and payers will no
longer accept ICD-9 codes. Physician offices have just a little under a year to prepare for the transition to
the ICD-10-CM diagnosis code sets. For years, HHS has been pushing to adopt the updated ICD-10 code
standard that was endorsed by the WHO in 1990, and whose adoption was relatively swift in most of the
world with the notable exception of the United States.
Reasons given by HHS for adopting ICD-10 include:
• ICD-9 is outdated with only a limited ability to accommodate new procedures and diagnoses.
• ICD-9 lacks specificity and detail, uses terminology inconsistently, cannot capture new
technology and lacks codes for preventive services; other alleged benefits:
o ICD-10, with its increased specificity, will accurately label someone with the correct
disease, sign/symptoms, or problem, as well as support the level of service provided.
o ICD-10 will decrease the amount of rejected endoscopy claims since the increased
specificity will directly link location of specific diagnoses within multiple endoscopy
claims.
o ICD-10 use will improve disease management with standardization of disease monitoring
and reporting internationally.
• ICD-9 will eventually run out of space. Currently there are approximately 17,000 ICD-9
diagnosis codes compared to over 79,000 ICD-10 codes as of July 2013. As of October 1, 2013,
the ICD-10 codes increased to over 91,000. For a complete listing of all ICD-10 codes, access:
o https://www.cms.gov/Medicare/Coding/ICD10/2014-ICD-10-CM-and-GEMs.html
Fortunately for gastroenterology and hepatology, the vast majority of the current ICD-9 codes will
map cleanly to an ICD-10-CM code.
Practice Management
