2013 ACR/ARHP Annual Meeting: Rheumatologists Must Prepare for ICD-10 Coding System

SAN DIEGO—Despite efforts to delay its implementation and widespread groans about its massive complexity, the new International Statistical Classification of Diseases and Related Health Problems, better known as ICD-10, will take effect on October 1, 2014, a coding expert told an audience of rheumatologists here at the 2013 ACR/ARHP Annual Meeting, held October 26–30. [Editor’s Note: This session was recorded and is available via ACR SessionSelect at www.rheumatology.org.]

Complex System of Codes

The previous set of 14,025 codes to describe patient diagnosis and treatment details, ICD-9, has been in place for about 30 years, but this system from the World Health Organization (WHO) can no longer sustain or support additional codes, said Antanya Chung, CPC, CPC-I, CRHC, CCP, director of practice management for the ACR in Atlanta. So the WHO created the more detailed ICD-10, a set of 68,069 codes of three to seven characters each. “ICD-10 is very specific, and has laterality. This specificity improves coding accuracy and the depth of data for analysis,” said Chung. However, rheumatologists and their staff may find learning the new codes a cumbersome, time-consuming process, she acknowledged.

Rheumatologists will mainly use the codes in Chapter 13, “Diseases of the musculoskeletal system and connective tissue,” Chung noted, holding up the thick book that contains a list of the new codes. The first three alphanumeric characters of new codes will point to major categories of rheumatic disease, while the rest of the characters will represent subcategories to specify data like affected joints or the presence of certain inflammatory markers in the blood. Chapter 13 contains codes with the prefixes M00–M99, she said.

“It’s not going to come so easily, to know these codes automatically. It is going to be a learning curve,” Chung advised the audience members, who vocally expressed their concerns about the time it will take to master the more complex coding system. The ACR is providing assistance, including developing an online training tool, and access to two full-time staff members to help rheumatologists adjust, she said. She advised rheumatologists to order the full ICD-10 book to cover all the potential patient cases they may encounter. For example, ICD-10’s Chapter 18 covers symptoms, signs, and abnormal clinical and laboratory findings not elsewhere classified.