What Is ICD 10 — The 2016 ICD-10 Codes & Guidelines

What is ICD 10?

The International Classification of Diseases, Tenth Edition (ICD–10) is a clinical cataloging system that goes into effect for the U.S. healthcare industry on Oct. 1, 2015, after a series of lengthy delays which will be split into two systems: ICD-10-CM (Clinical Modification) for diagnostic coding and ICD-10-PCS (Procedure Coding System) for inpatient hospital procedure coding.

What is ICD-10-CM?

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) is a system published by the World Health Organization (WHO) which uses unique alphanumeric codes to identify known diseases and other health problems. According to WHO, physicians, coders, health information managers, nurses and other healthcare professionals also use ICD-10-CM to assist them in the storage and retrieval of diagnostic information. ICD records are also used in the compilation of national mortality and morbidity statistics.

The ICD-10-CM revision includes more than 68,000 diagnostic codes, compared to 13,000 in ICD-9-CM. In addition, ICD-10-CM codes include twice as many categories. ICD-10-CM diagnosis codes consist of three to seven digits, compared to the three to five digit system of ICD-9-CM. The increase in the amount and length of ICD-10-CM codes will allow for greater coding specificity. Source: http://searchhealthit.techtarget.com/definition/ICD-10-CM

What is ICD-10-PCS?

The International Classification of Diseases 10th Revision Procedure Coding System (ICD-10-PCS) has been developed as a replacement for Volume 3 of the International Classification of Diseases 9th Revision (ICD-9-CM). The development of ICD-10-PCS was funded by the U.S. Centers for Medicare and Medicaid Services (CMS).1 ICD-10- PCS has a multiaxial seven character alphanumeric code structure that provides a unique code for all substantially different procedures, and allows new procedures to be easily incorporated as new codes.

The procedure coding system, ICD-10-PCS, developed and approved as a replacement for ICD-9-CM, Volume 3, can be viewed and downloaded from the Centers for Medicare and Medicaid Services’ Web sit. Source: https://www.cms.gov/Medicare/Coding/ICD10/2016-ICD-10-PCS-and-GEMs.html

ICD 9 to ICD 10: The Future of ICD 10 VIDEO

2016 ICD-10 Codes List and ICD-10 Codes Download

FY 2016 release of ICD-10-CM and GEMS

Note: This replaces the FY 2015 release.

The 2016 ICD-10-CM files below contain information on the new diagnosis coding system, ICD-10-CM, that is a replacement for ICD-9-CM, Volumes 1 and 2.

Source: https://www.cms.gov/Medicare/Coding/ICD10/2016-ICD-10-CM-and-GEMs.html

FY 2016 release of ICD-10-PCS and GEMS

The 2016 ICD-10 Procedure Coding System (ICD-10-PCS) files below contain information on the new procedure coding system, ICD-10-PCS, that is a replacement for ICD-9-CM, Volume 3.

Although the FY 2016 ICD-10-CM and FY 2016 ICD-10-PCS are now available for public download and viewing, the codes in ICD-10-CM (and ICD-10-PCS) are not currently valid for any purpose or use. Please see above regarding the final rule for details related to the implementation of ICD-10-CM (and ICD-10-PCS), with the date October 1, 2015. Updates to ICD-10-CM are not anticipated prior to its implementation. Source: https://www.cms.gov/Medicare/Coding/ICD10/2016-ICD-10-PCS-and-GEMs.html

Difference Between ICD 9 and ICD 10

The implementation of ICD-10 CM/PCS signals an upgrade in the country’s current classification system.The differences between the two are fairly significant. Here are a couple of areas where they differ: There are approximately 17,000 codes available for use with ICD-9 CM. The adoption of ICD-10 CM/PCS will make more than 155,000 codes available and will aid in the implementation of new codes as the evolution of medical technology and medical procedures continues. In effect, ICD-10 is more detailed than ICD-9. Source: http://www.northcrest.com/icd-10/what-is-the-difference-between-icd-9-and-icd-10/

ICD-9 CM (Diagnosis Codes)	ICD-10 CM (Diagnosis Codes)
Consists of 3-5 digits	Consists of 3-7 characters
First digit is alpha or numeric (E or V)	First character is always alpha
Second-fifth digits are numeric	Second character is numeric
Limited space for adding new codes	Flexibility for adding new codes
Decimal placed after the first 3 digits	Decimal placed after the third character
Alpha characters are not case sensitive	Characters 3-7 can be alpha or numeric
14,000 codes	Approximately 68,000 codes

ICD -9 CM Volume 3 (Procedure Codes)	ICD-10 PCS (Procedure Codes)
ICD-9-CM has 3-4 digits. A decimal is placed after the 2^nd digit.	ICD-10 PCS has 7 characters and no decimals
All digits are numeric	Each character can be alpha or numeric
	Numbers 0-9; letters A-H, J-N, P-Z. The letters I and O are not used to avoid confusion with one and zero.
All codes must have at least 3 digits	Each code must have 7 characters
Generic body parts	Detailed descriptions of body parts
3,000 codes	87,000 codes

The ICD-10 code sets are not a simple update of the ICD-9 code set. The ICD-10 code sets have fundamental changes in structure and concepts that make them very different from ICD-9. Because of these differences, it is important to develop a preliminary understanding of the changes from ICD-9 to ICD-10. This basic understanding of the differences will then identify more detailed training that will be needed to appropriately use the ICD-10 code sets. In addition, seeing the differences between the code sets will raise awareness of the complexities of converting to the ICD-10 codes. Source: https://www.unitypoint.org/waterloo/filesimages/for%20providers/icd9-icd10-differences.pdf

The ICD-10 code sets are not simply increased and renumbered ICD-9 code sets. The move to ICD-10 will not be easy. The ICD-10 code sets include greater detail, changes in terminology, and expanded concepts for injuries, laterality, and other related factors. The complexity of ICD-10 provides many benefits because of the increased level of detail conveyed in the codes. The complexity also underscores the need to be adequately trained on ICD-10 in order to fully understand reporting changes that will come with the new code sets. Source: https://www.unitypoint.org/waterloo/filesimages/for%20providers/icd9-icd10-differences.pdf