Procedure coding in the American Joint Replacement Registry.

Area of Science:

• Medical Coding and Health Informatics
• Orthopedic Surgery Data Management

Background:

• The Centers for Medicare & Medicaid Services (CMS) mandated a transition from International Classification of Diseases, 9th Edition (ICD-9) to 10th Edition (ICD-10) in October 2015.
• The International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) introduced a significantly larger number of codes, particularly for total joint arthroplasty procedures.

Purpose of the Study:

• To address challenges faced by the American Joint Replacement Registry (AJRR) in accurately identifying specific total joint arthroplasty procedures under the new ICD-10-PCS coding system.
• To improve the precision and reliability of data collected by the AJRR.

Main Methods:

• Formation of an ICD-10 workgroup by the AJRR.
• Definition and mapping of appropriate ICD-10 codes to various total joint procedure types.
• Collaboration between AJRR and participating hospitals/surgeons to navigate the new coding system.

Main Results:

• The AJRR workgroup successfully developed a framework for mapping ICD-10-PCS codes to total joint arthroplasty procedures.
• Enhanced understanding and familiarity with ICD-10-PCS among AJRR stakeholders, including surgeons.
• Improved data accuracy and specificity within the AJRR database.

Conclusions:

• The AJRR's proactive approach in establishing an ICD-10 workgroup effectively mitigated challenges posed by the ICD-10-PCS transition.
• Accurate procedural coding is crucial for the integrity of large joint replacement registries.
• Continued education and clear mapping are essential for successful adoption of new medical coding systems.