How Will the Transition to ICD-10 Affect Urology Coding? An Analysis of ICD-9 Code Use from a Large Group Practice

On October 1, 2015 the ICD (International Classification of Diseases)-10-CM (10th Revision, Clinical Modification) code set replaced ICD-9 (9th Revision) for coding medical encounters in the United States. The introduction of this unique, expanded code set will change the way medical encounters are coded, and may affect specialties and subspecialists to different degrees.

A retrospective review was performed evaluating ICD-9 codes used at a large urology group. The most commonly used codes were evaluated in the office and hospital settings, and also from 3 individual subspecialists including a men's health/infertility subspecialist, a pelvic floor/reconstruction subspecialist and a pediatric subspecialist.

The top 30 ICD-9 codes comprised 82.5% and 80.7% of the codes chosen in the office and hospital settings, with a 1:1 conversion from ICD-10 in 60% (18 of 30) and 36.7% (11 of 30), respectively. The top 25 codes from the 3 subspecialists (men's health/infertility, pelvic floor/reconstruction and pediatric) comprised 86.8%, 88.7% and 88.1% of the ICD-9 codes chosen, with a 1:1 correlation in 48% (12 of the top 25), 56% (14 of 25) and 40% (10 of 25), respectively. A significant number of unspecified codes was used across all of the aspects of practice.

Urologists need to be aware of their practice patterns when converting from ICD-9 to ICD-10. The high percentage of codes concentrated in the top 25 of a practice may allow urologists to focus on their individual needs. Improved documentation and coding education may decrease the number of unspecified codes chosen, leading to improved coding accuracy.