PART 2
Countdown to ICD-10...
Tips for a Smooth & Effective
Transition
Cindy Cain, BSHA, CPC,
CPC-H, CCS-P, CHC
Senior Manager, Consulting
June 23,2015
• Identifying complex ICD-10 transitional codes
• Highlighting transitions from ICD-9 to ICD-10 and
the necessary changes
• Developing steps necessary to improve clinical
documentation
2
Objectives
Recap from Part 1
7/15/2015 McKesson Corporation Confidential and Proprietary 4
Recap from Part 1
A Quick Overview
ICD-10-CM replaces ICD-9CM for
diagnosis coding
(Captures more
specific data from clinical documentation than
ICD-9)
:
•
ICD-9-CM diagnosis codes = 3 to 5
digits
•
ICD-10-CM codes = 3 to 7 digits
•
Overall format of ICD-10 diagnosis
codes similar to ICD-9
What we uncovered
•
The majority of attendees
were less than 25% ready for
the transition
•
73% of attendees felt that
inadequate documentation of
medical records would have
the most significant impact on
their practice
Polling Question #1
5 7/15/2015 McKesson Corporation Confidential and Proprietary
How far along are you in your
transition to ICD-10?
(Select one)
1. 0-25%
2. 50%
3. 75%
Is Your Organization Ready?
Transitional Codes
7
Several different combinations
Mapping Categories
ICD-10 to ICD-9
ICD-9 to ICD-10
No Match
1.2%
3.0%
1-to-1 Exact Match
5.0%
24.2%
1-to-1 Approximate Match with 1 Choice
82.6%
49.1%
1-to-1 Approximate Match with Multiple
Choices
4.3%
18.7%
1-to-Many Match with 1 Scenario
6.6%
2.1%
1-to-Many Match with Multiple Scenarios
0.2%
2.9%
Transitional Codes
8
Several different combinations - EXAMPLES
Transitional Codes
9
Several different combinations - EXAMPLES
Transitional Codes
10
Several different combinations - EXAMPLES
Transitional Codes
11
Several different combinations - EXAMPLES
Transitional Codes
12
ICD-9-CM to ICD-10-CM Mapping
Specialty
ICD-9-CM Code Descriptor
ICD-10-CM Code Descriptor
Family Medicine/Podiatry
250.60 Diabetes with neurological
manifestations, type II or unspecified type, not
stated as uncontrolled
E11.40 Type 2 diabetes mellitus with diabetic
neuropathy, unspecified
E11.41 Type 2 diabetes mellitus with diabetic
mononeuropathy
E11.42 Type 2 diabetes mellitus with diabetic
polyneuropathy
E11.43 Type 2 diabetes mellitus with diabetic
autonomic (poly)neuropathy
E11.44 Type 2 diabetes mellitus with diabetic
amyotrophy
E11.49 Type 2 diabetes mellitus with other diabetic
neurological complication
E11.610 Type 2 diabetes mellitus with diabetic
neuropathic arthropathy
E13.40 Other specified diabetes mellitus with diabetic
neuropathy, unspecified
E13.41 Other specified diabetes mellitus with diabetic
mononeuropathy
E13.42 Other specified diabetes mellitus with diabetic
polyneuropathy
E13.43 Other specified diabetes mellitus with diabetic
autonomic (poly)neuropathy
E13.44 Other specified diabetes mellitus with diabetic
amyotrophy
E13.49 Other specified diabetes mellitus with other
diabetic neurological complication
E13.610 Other specified diabetes mellitus with
diabetic neuropathic arthropathy
Transitional Codes
13
ICD-9-CM to ICD-10-CM Mapping
Specialty
ICD-9-CM Code Descriptor
ICD-10-CM Code Descriptor
Podiatry 713.5 Arthropathy associated with neurological disorders
A52.16 Charcot's arthropathy (tabetic)
E08.610 Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy
E09.610 Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy
E10.610 Type 1 diabetes mellitus with diabetic neuropathic arthropathy
E11.610 Type 2 diabetes mellitus with diabetic neuropathic arthropathy
E13.610 Other specified diabetes mellitus with diabetic neuropathic arthropathy
M14.60 Charcot's joint, unspecified site M14.611 Charcot's joint, right shoulder M14.612 Charcot's joint, left shoulder
M14.619 Charcot's joint, unspecified shoulder M14.621 Charcot's joint, right elbow
M14.622 Charcot's joint, left elbow M14.629 Charcot's joint, unspecified elbow M14.631 Charcot's joint, right wrist
M14.632 Charcot's joint, left wrist
M14.639 Charcot's joint, unspecified wrist M14.641 Charcot's joint, right hand M14.642 Charcot's joint, left hand
M14.649 Charcot's joint, unspecified hand M14.651 Charcot's joint, right hip
M14.652 Charcot's joint, left hip M14.659 Charcot's joint, unspecified hip M14.661 Charcot's joint, right knee M14.662 Charcot's joint, left knee M14.669 Charcot's joint, unspecified knee
M14.671 Charcot's joint, right ankle and foot M14.672 Charcot's joint, left ankle and foot M14.679 Charcot's joint, unspecified ankle and foot M14.68 Charcot's joint, vertebrae
Transitional Codes
14
ICD-9-CM to ICD-10-CM Mapping
Specialty
ICD-9-CM Code Descriptor
ICD-10-CM Code Descriptor
OMM
782.0 Disturbance of skin sensation
R20.0 Anesthesia of skin
R20.1 Hypoesthesia of skin
R20.2 Paresthesia of skin
R20.3 Hyperesthesia
R20.8 Other disturbances of skin sensation
R20.9 Unspecified disturbances of skin sensation
Transitional Codes
15
ICD-9-CM to ICD-10-CM Mapping
Specialty
ICD-9-CM Code Descriptor
ICD-10-CM Code Descriptor
Fam Med/OMM/PT/Podiatry
729.5 Pain in limb
M79.601 Pain in right arm
M79.602 Pain in left arm
M79.603 Pain in arm, unspecified
M79.604 Pain in right leg
M79.605 Pain in left leg
M79.606 Pain in leg, unspecified
M79.609 Pain in unspecified limb
M79.621 Pain in right upper arm
M79.622 Pain in left upper arm
M79.629 Pain in unspecified upper arm
M79.631 Pain in right forearm
M79.632 Pain in left forearm
M79.639 Pain in unspecified forearm
M79.641 Pain in right hand
M79.642 Pain in left hand
M79.643 Pain in unspecified hand
M79.644 Pain in right finger(s)
M79.645 Pain in left finger(s)
M79.646 Pain in unspecified finger(s)
M79.651 Pain in right thigh
M79.652 Pain in left thigh
M79.659 Pain in unspecified thigh
M79.661 Pain in right lower leg
M79.662 Pain in left lower leg
M79.669 Pain in unspecified lower leg
M79.671 Pain in right foot
M79.672 Pain in left foot
M79.673 Pain in unspecified foot
M79.674 Pain in right toe(s)
M79.675 Pain in left toe(s)
M79.676 Pain in unspecified toe(s)
Transitional Codes
16
ICD-9-CM to ICD-10-CM Mapping
Specialty
ICD-9-CM Code Descriptor
ICD-10-CM Code Descriptor
OPhysical Therapy 362.01 Background diabetic retinopathy
E08.311 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema E08.319 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema E08.331 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema E08.339 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema
E08.341 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema E08.349 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema E09.311 Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edema E09.319 Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy without macular edema E09.331 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema E09.339 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema E09.341 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema E09.349 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema
E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema
E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema
E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema
E13.311 Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema
E13.319 Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema
Transitional Codes
17
ICD-9-CM to ICD-10-CM Mapping
Specialty
ICD-9-CM Code Descriptor
ICD-10-CM Code Descriptor
OPhysical Therapy
362.11 Hypertensive retinopathy
H35.031 Hypertensive retinopathy, right eye
H35.032 Hypertensive retinopathy, left eye
H35.033 Hypertensive retinopathy, bilateral
H35.039 Hypertensive retinopathy, unspecified
eye
OPhysical Therapy
365.11 Primary open angle glaucoma
H40.11X0 Primary open-angle glaucoma, stage
unspecified
H40.11X1 Primary open-angle glaucoma, mild
stage
H40.11X2 Primary open-angle glaucoma,
moderate stage
H40.11X3 Primary open-angle glaucoma, severe
stage
H40.11X4 Primary open-angle glaucoma,
indeterminate stage
Transitional Codes
18
ICD-9-CM to ICD-10-CM Mapping
Specialty
ICD-9-CM Code Descriptor
ICD-10-CM Code Descriptor
OPhysical Therapy 250.50 Diabetes with ophthalmic manifestations, type II or
unspecified type, not stated as uncontrolled
E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema E11.321 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema E11.329 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema E11.331 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema
E11.339 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema
E11.341 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema E11.349 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema
E11.351 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema E11.359 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema E11.36 Type 2 diabetes mellitus with diabetic cataract
E11.39 Type 2 diabetes mellitus with other diabetic ophthalmic complication
E13.311 Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema E13.319 Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema E13.321 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema
E13.329 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema
E13.331 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema
E13.339 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema
E13.341 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema
E13.349 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema
E13.351 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema E13.359 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema E13.36 Other specified diabetes mellitus with diabetic cataract
Transitional Codes
19
ICD-9-CM to ICD-10-CM Mapping
Specialty
ICD-9-CM Code Descriptor
ICD-10-CM Code Descriptor
OPhysical Therapy 365.71 Mild stage glaucoma
H40.10X1 Unspecified open-angle glaucoma, mild stage H40.11X1 Primary open-angle glaucoma, mild stage H40.1211 Low-tension glaucoma, right eye, mild stage H40.1221 Low-tension glaucoma, left eye, mild stage H40.1231 Low-tension glaucoma, bilateral, mild stage H40.1291 Low-tension glaucoma, unspecified eye, mild stage H40.1311 Pigmentary glaucoma, right eye, mild stage H40.1321 Pigmentary glaucoma, left eye, mild stage H40.1331 Pigmentary glaucoma, bilateral, mild stage H40.1391 Pigmentary glaucoma, unspecified eye, mild stage
H40.1411 Capsular glaucoma with pseudoexfoliation of lens, right eye, mild stage H40.1421 Capsular glaucoma with pseudoexfoliation of lens, left eye, mild stage H40.1431 Capsular glaucoma with pseudoexfoliation of lens, bilateral, mild stage H40.1491 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, mild stage H40.20X1 Unspecified primary angle-closure glaucoma, mild stage
H40.2211 Chronic angle-closure glaucoma, right eye, mild stage H40.2221 Chronic angle-closure glaucoma, left eye, mild stage H40.2231 Chronic angle-closure glaucoma, bilateral, mild stage H40.2291 Chronic angle-closure glaucoma, unspecified eye, mild stage H40.30X1 Glaucoma secondary to eye trauma, unspecified eye, mild stage H40.31X1 Glaucoma secondary to eye trauma, right eye, mild stage H40.32X1 Glaucoma secondary to eye trauma, left eye, mild stage H40.33X1 Glaucoma secondary to eye trauma, bilateral, mild stage
H40.40X1 Glaucoma secondary to eye inflammation, unspecified eye, mild stage H40.41X1 Glaucoma secondary to eye inflammation, right eye, mild stage H40.42X1 Glaucoma secondary to eye inflammation, left eye, mild stage H40.43X1 Glaucoma secondary to eye inflammation, bilateral, mild stage H40.50X1 Glaucoma secondary to other eye disorders, unspecified eye, mild stage H40.51X1 Glaucoma secondary to other eye disorders, right eye, mild stage H40.52X1 Glaucoma secondary to other eye disorders, left eye, mild stage H40.53X1 Glaucoma secondary to other eye disorders, bilateral, mild stage H40.60X1 Glaucoma secondary to drugs, unspecified eye, mild stage H40.61X1 Glaucoma secondary to drugs, right eye, mild stage H40.62X1 Glaucoma secondary to drugs, left eye, mild stage H40.63X1 Glaucoma secondary to drugs, bilateral, mild stage
Transitional Codes
20
ICD-9-CM to ICD-10-CM Mapping
Specialty
ICD-9-CM Code
Descriptor
ICD-10-CM Code Descriptor
Podiatry 454.0 Varicose veins of lower extremities with ulcer
I83.001 Varicose veins of unspecified lower extremity with ulcer of thigh I83.002 Varicose veins of unspecified lower extremity with ulcer of calf I83.003 Varicose veins of unspecified lower extremity with ulcer of ankle
I83.004 Varicose veins of unspecified lower extremity with ulcer of heel and midfoot I83.005 Varicose veins of unspecified lower extremity with ulcer other part of foot I83.008 Varicose veins of unspecified lower extremity with ulcer other part of lower leg I83.009 Varicose veins of unspecified lower extremity with ulcer of unspecified site I83.011 Varicose veins of right lower extremity with ulcer of thigh
I83.012 Varicose veins of right lower extremity with ulcer of calf I83.013 Varicose veins of right lower extremity with ulcer of ankle
I83.014 Varicose veins of right lower extremity with ulcer of heel and midfoot I83.015 Varicose veins of right lower extremity with ulcer other part of foot I83.018 Varicose veins of right lower extremity with ulcer other part of lower leg I83.019 Varicose veins of right lower extremity with ulcer of unspecified site I83.021 Varicose veins of left lower extremity with ulcer of thigh
I83.022 Varicose veins of left lower extremity with ulcer of calf I83.023 Varicose veins of left lower extremity with ulcer of ankle
I83.024 Varicose veins of left lower extremity with ulcer of heel and midfoot I83.025 Varicose veins of left lower extremity with ulcer other part of foot I83.028 Varicose veins of left lower extremity with ulcer other part of lower leg I83.029 Varicose veins of left lower extremity with ulcer of unspecified site
Podiatry
681.10 Cellulitis and abscess,
unspecified
L02.611 Cutaneous abscess of right foot
L02.612 Cutaneous abscess of left foot
L02.619 Cutaneous abscess of unspecified foot
L03.031 Cellulitis of right toe
L03.032 Cellulitis of left toe
L03.039 Cellulitis of unspecified toe
L03.041 Acute lymphangitis of right toe
L03.042 Acute lymphangitis of left toe
Transitional Codes
21
ICD-9-CM to ICD-10-CM Mapping
Specialty
ICD-9-CM Code Descriptor
ICD-10-CM Code Descriptor
OMM 723.0 Spinal stenosis in cervical region
M48.01 Spinal stenosis, occipito-atlanto-axial region M48.02 Spinal stenosis, cervical region
M48.03 Spinal stenosis, cervicothoracic region
M99.20 Subluxation stenosis of neural canal of head region M99.21 Subluxation stenosis of neural canal of cervical region
M99.30 Osseous stenosis of neural canal of head region M99.31 Osseous stenosis of neural canal of cervical region M99.40 Connective tissue stenosis of neural canal of head region
M99.41 Connective tissue stenosis of neural canal of cervical region
M99.50 Intervertebral disc stenosis of neural canal of head region
M99.51 Intervertebral disc stenosis of neural canal of cervical region
M99.60 Osseous and subluxation stenosis of intervertebral foramina of head region
M99.61 Osseous and subluxation stenosis of intervertebral foramina of cervical region
M99.70 Connective tissue and disc stenosis of intervertebral foramina of head region
M99.71 Connective tissue and disc stenosis of intervertebral foramina of cervical region
Family Medicine/OMM 780.79 Other malaise and fatigue
G93.3 Postviral fatigue syndrome
R53.0 Neoplastic (malignant) related fatigue R53.1 Weakness
R53.81 Other malaise R53.83 Other fatigue
Transitional Codes
22
ICD-9-CM to ICD-10-CM Mapping
Specialty
ICD-9-CM Code Descriptor
ICD-10-CM Code Descriptor
OPhysical Therapy 918.1 Superficial injury of cornea
S05.00XA Injury of conjunctiva and corneal abrasion without foreign body, unspecified eye, initial encounter
S05.00XD Injury of conjunctiva and corneal abrasion without foreign body, unspecified eye, subsequent encounter
S05.00XS Injury of conjunctiva and corneal abrasion without foreign body, unspecified eye, sequela
S05.01XA Injury of conjunctiva and corneal abrasion without foreign body, right eye, initial encounter
S05.01XD Injury of conjunctiva and corneal abrasion without foreign body, right eye, subsequent encounter
S05.01XS Injury of conjunctiva and corneal abrasion without foreign body, right eye, sequela
S05.02XA Injury of conjunctiva and corneal abrasion without foreign body, left eye, initial encounter
S05.02XD Injury of conjunctiva and corneal abrasion without foreign body, left eye, subsequent encounter
S05.02XS Injury of conjunctiva and corneal abrasion without foreign body, left eye, sequela
Family Medicine V20.2 Routine infant or child health check
Z00.121 Encounter for routine child health examination with abnormal findings
Z00.129 Encounter for routine child health examination without abnormal findings
Family Medicine V70.0 Routine general medical examination at a health care facility
Z00.00 Encounter for general adult medical examination without abnormal findings
Z00.01 Encounter for general adult medical examination with abnormal findings
Family Medicine V70.5 Health examination of defined subpopulations
Z02.0 Encounter for examination for admission to educational institution
Z02.1 Encounter for pre-employment examination Z02.2 Encounter for examination for admission to residential institution
Z02.3 Encounter for examination for recruitment to armed forces Z02.4 Encounter for examination for driving license
Z02.89 Encounter for other administrative examinations
Family Medicine V77.91 Screening for lipoid disorders
Polling Question #2
23 7/15/2015 McKesson Corporation Confidential and Proprietary
Do you think your practice has
the necessary tools in place to
excel during the transition?
1. Yes
2. No
Transitional Codes
24
Submitted by You
I work for an ASC in NJ. This is the one
we use that will be more complex with
the ICD-10 transition 365.70 Glaucoma
Stage Unspecified.
7/15/2015 McKesson Corporation Confidential and Proprietary 25
Centers for Medicare & Medicaid Services:
www.cms.gov
American Medical Association:
http://www.nationalfamilyplanning.org/document.doc?id=780
Resources
Questions
26 7/15/2015 McKesson Corporation Confidential and Proprietary
