Many people in health care have heard that something called ICD-10 is coming, but not everyone knows just what it is.

ICD-10 stands for International Classification of Diseases, Version 10, and it’s the first major change in diagnosis coding in the United States since 1979. It’s significant because it more fully describes both existing and new diseases, treatments, and injuries than before. It expands upon what’s turned out to be a limited standard that, at the same time, will both make the process more flexible and confusing at the same time.

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The biggest change in coding is expanding the code fields from five fields to seven. There will still be the first 3 fields that can stand alone as a diagnosis, but that will become rarer as the fields after the period expand from 2 to 4 placeholders, with the intention being to better specify exactly what’s taking place.

There will be two very significant changes to both the 3 codes before the period and after the period. The codes before the period will now begin with an alpha figure rather than a numerical figure. Twenty-one of the 26 letters of the alphabet will be used; the excluded letters are B, T, W, Y and X.

What’s also different is that the 4 subcategories at the end won’t necessarily fall into place in menu form as they do now. It’s possible that a particular diagnosis might use 3 of the 4 subcategories, which would include the 7th digit, but not have anything specific for a previous subcategory. In that case, the letter X would be used as a placeholder, and it must be used to make the entire code valid.

The number of codes that need to be learned by medical records coders jumps from 14,000 to more than 111,000 codes, and these codes need to be learned by October 2015. What’s more is that in some states coders will still need to retain knowledge of how to code ICD-9 because federal regulations don’t force workers compensation or no fault carriers to adopt these standards; at least not yet.

It’s going to take a lot of planning from hospitals, clinics and physicians to figure out how to get their staff trained for the new codes while still keeping up with the coding that exists now. Twenty-two months might seem like a long time, but in the scope of things it’s a limited period to get it all completed. Struggles are predicted, but one can only hope that every health care entity in the country has already begun preparations for the inevitable.

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