Coding
ICD-10 Will Allow Dermatologists to Effectively Communicate With Payors About Patient Visits
It is important that dermatologists do not overlook the changes associated with the transition to International Classification of Diseases, Tenth...
As I have mentioned in prior columns, the key to success with International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding will be additional specificity, which will come in the form of more characters to communicate with payors and statisticians regarding the services that have been provided during the office visit. The addition of characters will permit more information about the visit to be delivered in the code.
Some of these additional characters will be required to submit the code for processing. Specifically look out for codes that communicate accidents or injury. Some common circumstances for dermatologists will be lacerations, abrasions, laceration repairs, and burns. The structure of the ICD-10-CM codes is outlined below to explain circumstances in which the increased number of characters will be most important for dermatologists.
The ICD-10-CM codes will be 3 to 7 characters long.1 The first 3 characters are the general categories. For example, L70 is the 3-character category for acne and L40 is the category for psoriasis. The next 3 characters (ie, characters 4–6) correspond to the related etiology (ie, the cause, set of causes, manner of causation of a disease or condition), anatomic site, severity, and other vital clinical details.1
Take the case of a burn on the hand. With the International Classification of Diseases, Ninth Revision, a first-degree burn on the back of the hand is coded with 5 characters (944.16).2 According to the ICD-10-CM coding system, the code for an initial visit for a first-degree burn on the back of the hand would include 7 characters (T23.169A).1 There will be times when the sixth character may not be necessary; in these instances, an X must be placed in this position as a placeholder, but the absence of a sixth character does not negate the need for a seventh. Thankfully, the seventh character can only be 1 of 3 letters. As illustrated above in the code for a first-degree burn on the back of the hand, the A designates an initial encounter; a D would designate a follow-up visit for this burn, and an S would represent a sequela from the initial burn, such as a postinflammatory change, which would have its own code.1
Conclusion
To be reimbursed, appropriate ICD-10-CM codes must be used. Be sure to master the structure of these codes before the October 1, 2015, compliance deadline; plan now for a training and testing period.
