Health Information Management

Increased specificity leads to better coding

HIM-HIPAA Insider, August 18, 2014

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ICD-10-CM includes 68,000 codes and ICD-10-PCS features 71,924 code choices. Scary numbers, right?

Not according to Sue Bowman, RHIA, CCS, senior director of coding policy and compliance for AHIMA in Chicago.
 
All of those codes will actually make it easier to find the code that best represents either the patient’s diagnosis or the procedure the physician performed.
 
Some ICD-9-CM codes are vague. By now, you’ve probably seen the comparisons for fracture codes. ICD-9-CM may include only two code choices for a particular fracture (open or closed), while ICD-10-CM can offer more than 100 (sometimes more than 200) codes, which include laterality, specific site of the fracture, type of fracture, and encounter.
 
Sue likes to compare the code book to a phone book. If you look at the New York City phone book, you’ll find lots and lots of names. More than 8 million people call the Big Apple home. By contrast, Schenectady, New York, is home to slightly more than 66,000 people and requires a much smaller phone book.
You’ll still look up a name the same way. You just have more names to sort through in New York City.
 
Same holds true for ICD-10-CM. (ICD-10-PCS is very different than ICD-9-CM Vol. 3).
 
You still look in the Alphabetic Index, you still go to the Tabular List to double check the code. The only difference is you have more code choices.
 
Increase specificity makes it easier to assign a code because it takes some of the guess work out of the process, Sue says.
 
That’s especially true in ICD-10-PCS. The ICD-9-CM Vol. 3 codes are so vague that one code could represent more than 100 procedures. Talk about ambiguity!
 
With all of the code choices in ICD-10-PCS, you’re more likely to find a code that represents what the physician actually did. And that should save time in the long. It will certainly give us more accurate data about the patient and allow us to tell a better story about the patient’s health.
 
This article originally appeared on HCPro’s ICD-10 Trainer blog.

 



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