With no word from the Centers for Medicare and Medicaid Services about a revised timeline for ICD-10-CM/PCS implementation, there has been quite a slow down in web articles about ICD-10-CM hints. This is surprising. You would think that the industry would take the opportunity to gear up and seize the moment. I think it highlights a human reality that procrastination is real (and possibly default). Last minute deadlines are often the only thing that mobilizes us. I am already preparing myself for the new round of griping about a looming deadline due a year from now.
Even so, there are few good articles that are trickling out that focus on the few practical differences between ICD-9 and ICD-10. Rhonda Butler of 3M just authored a helpful, brief article for OB/GYNs with excellent ICD-10-CM hints.
She divides the article into Obstetrics and Gynecology. For obstetrics, the key organizer of the diagnostic coding is time. Codes are broken down by the trimester of the pregnancy (something recorded during every encounter), labor, or postpartum period. Complications are simply diagnoses now that affect the gestation, labor, or delivery. They can be concurrent diseases that impact the pregnancy or conditions related to or stemming from the pregnancy. For example, O75.81 Maternal exhaustion complicating labor and delivery or O86.12 Endometritis following delivery.
There is more detail in ICD-10 such as anti-body incompatibilities, specific genitourinary locations for infections, and Strep B carrier state. Obsolete terminology is removed like whether an abortion was illegal.
Ms Butler had even less to report on changes in the gynecological diagnoses. The net increase was only 37 codes. These were largely due to the inclusion of laterality, other anatomic detail, or causative organisms in infections.
I think this article highlights a couple things. First, the logic of the ICD-10-CM is much more clinically relevant. If you have never coded before, ICD-10-CM is the easier system by far. Second, it demonstrates how professional associations should have or be taking the lead on ICD-10-CM readiness. The specialty-specific differences in the logic can be minimal at best. Other specialties certainly will require more training, but OB/GYNs should be confident that they will not miss a beat.
Let’s hope that while there are not as many ICD-10-CM hints articles right now, maybe the silence is actually the industry preparing itself.
