The 4 Questions to Ask and Answer Regarding ICD-10: First of a 2-Part Series

On October 1, 2015 the International Classification of Diseases and Related Health Problems, 9th revision (ICD-9) will be replaced by the 10th revision (ICD-10) for coding medical encounters in the United States. This transition will fundamentally change how medical care is documented, how health care is delivered and how delivery systems operate. We will shed light on the ICD-10 transition and answer 4 questions we believe to be important to this transition. We first wanted to know 1) how ICD-10 differs from ICD-9 and 2) why we need to do this/what frustrations we might expect.

A search was undertaken regarding the transition from ICD-9 to ICD-10, and included input and expertise from coding experts as well as personal experience.

ICD-10 differs from ICD-9 in a number of ways, not just in the extreme expansion in the number of codes and specificity. ICD-10 has a new structure and rules that must be understood. The proposed advantages of transitioning to ICD-10 include a better analysis of disease patterns, improved treatment outcomes, streamlined claims submissions and reduced overall health care costs. These "advantages" have been debated and not yet proved. The transition could be very expensive and very frustrating.

The transition to ICD-10 presents a significant implementation challenge for every health care provider and practice, and could be financially devastating to those who are unprepared. There is a significant cost to implementation, much of which is seemingly placed directly on health care providers. We must be prepared.