Beginning December 31, 2011, rheumatology practices will begin to see significant changes in how medical diagnoses are reported. The Centers for Medicare and Medicaid Services (CMS) has mandated that hospitals and medical practices adopt the International Classifications of Diseases, Tenth Revision (ICD-10) by October 1, 2013. The transition may provide many benefits, but also could be very expensive and time consuming for rheumatology practices.
“ICD-10 has been in use around the world outside of the United States since 1994,” says Jonathan Kay, MD, professor of medicine at the University of Massachusetts Medical School in Worcester. “The adoption of ICD-10 will bring the U.S. into conformity with the rest of the world and allow us all to speak the same language when describing diseases. After this change, the most significant advantage will be that data from American patients will be able to be captured using the same terminology as elsewhere in the world and can then be merged with data from other countries to better see patterns and burdens of disease.”
The World Health Organization (WHO) promulgates the ICD system as a consensus document. The WHO generally releases a set of codes as a baseline. Each country takes this document and creates its own version based on its needs.
ICD-10 has two different parts. The ICD-10PCS (or Procedural Coding System) is mostly used by hospitals to code for inpatient procedures. Individual practices of all sizes will be required to use ICD-10CM (Clinical Modifications).
New System More Robust
The new classification system is much more robust than the previous version. Currently, ICD-9-CM contains more than 17,000 codes while ICD-10 contains more than 141,000 codes and accommodates a host of new diagnoses and procedures. ICD-10 increases the number of digits that can be used from five to seven, allowing for much greater specificity when describing a diagnosis. (See “A New Era of Coding for Rheumatology Practices” on page 20 for more information on the new coding system.)
Unlike ICD-9, ICD-10 is structured more toward body systems. Most rheumatology codes will be in the musculoskeletal section. Codes will also be alphanumerical, instead of the current use of mainly numbers.
ICD-11 Revision in the Works
With all the attention being given to the ICD-10 changeover, it may be disconcerting to learn that the WHO is beginning work on the 11th edition of the system. However, most of the experts interviewed here don’t think that this will lead to another major change any time soon in the United States.