Vice President, Business Development
TCS Healthcare Technologies
ICD codes, International Statistical Classification of Diseases, are used around the world to identify the disease or medical condition of a person undergoing treatment. These codes were developed by the World Health Organization (WHO), and the ICD-9 version has been in use in the United States since the 1970’s. WHO developed a newer, more extensive ICD code set which was adopted in the 1990’s. These codes, the ICD-10, are used by most countries in the world, but the U.S. has been slow to make the change.
The federal government has mandated that ICD-10 codes must be used for Medicare and Medicaid claims beginning October 1, 2013. It is anticipated that all claims will use the new codes for reimbursement and reporting on that date.
The codes have been modified for use in the U.S., and the complete identification of the codes is ICD-10-CM, meaning that they have been clinically modified from the codes published by WHO.
The structure of the codes is changing, going from five numeric digits to seven alpha-numeric codes. And the number of codes is increasing significantly, from 17,000 to 69,000, with a similar increase in the number of ICD-10-PCS, procedure codes.
The ICD-9 code structure was out of room because of the limitation of the five digit numeric construction. ICD-10 codes allow for a more detailed description of the diagnosis. ICD-10 has room to accommodate new inpatient procedures of care that are already performed and new scientific causes of conditions that were not even imagined when ICD-9 codes were established. The codes also allow for greater specificity within the code itself, without requiring additional text or documentation. The new codes will allow for better analysis of disease patterns and treatment outcomes and it is anticipated that they will streamline claims submissions.
With this as background, TCS is actively working on a plan to incorporate ICD-10 codes into its products. A team was formed with members from management, clinical staff, and technical development staff to conduct a thorough review of the impact on TCS products and to propose a method to incorporate this regulatory change into the products. The team is focused on understanding the codes, identifying each TCS product that is impacted, and proposing alternatives for accommodating the change. After the research is complete and a design approved, work will begin on the coding and testing phases of this project. Our goal is to have this available to our clients by mid-2011, giving clients over two years to evaluate how the changes affect their organizations, plan for the transition period, and review workflows and reports.
The TCS team is striving to make the transition to ICD-10 codes as simple and straight forward as possible so that there is minimal disruption to our clients’ organization; at least as the change impacts TCS products. Going forward, TCS will keep its clients informed of the release dates for TCS products that support ICD-10 codes.