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ICD-10 Coding -15 years in the making

As October 1st, 2015 approaches, we as healthcare providers are all preparing for the new ICD-10 codes and some of us, including myself have been using them for months. As a reference, ICD stands for International Classification of Disease.

In 1990 the WHO (Would Health Organization) approved the 10th revision of the ICD – known as ICD-10. The purpose was to create a modified version in order to more accurately analyze health information due to a multitude of changes in disease states over the past several years.

Here are some interesting facts:

• Greater than 100 countries use ICD codes to help determine death and disease rates
• Approximately 70% of the world’s health expenditures are allocated by using ICD for reimbursement
• ICD-11 revision is scheduled to be released in 2018
• The first ICD edition (at which time was referred to as the International List of Causes of Death) was implemented in 1893

There are currently 13,000 codes with ICD-9, this will increase to 68,000 codes with ICD-10 version. The reason for significant more codes is to better specify the disease state for each individual patient. ICD-10 is required for everyone covered by HIPPA (Heath Insurance Portability Accountability Act).

ICD-9 codes have been used for decades and with significant changes in medicine and diagnoses it was necessary for new codes to be implemented. The ICD-10 codes are much more specific – often times grouped as a “family of codes.”

For example: A patient presents with Asthma. With the ICD 9 codes for asthma there were 14 options to specify asthma.

However with the new ICD-10 codes, in order to correctly describe asthma, providers must document the following:
• Cause of Asthma
o Exercise induced
o Related to smoking
o Cough variant
o Occupational

• Severity of Asthma
o Mild intermittent
o Mild persistent
o Moderate persistent
o Severe persistent

• Temporal Factors
o Acute
o Chronic
o Intermittent
o Persistent
o Status asthmaticus
o Acute exacerbation


J45.30 = mild persistent asthma, uncomplicated
J45.991 = cough variant asthma

As October 1st approaches healthcare providers are preparing for ICD-10 coding yet keep in mind ICD-11 codes are just around the corner!