Surgery Centers: Are You Ready for ICD-10?

While the transition from ICD-9 to ICD-10 may be a change to the codes for diagnoses and inpatient procedures, if you provide medical billing for a surgery center, the switch significantly affects your work as well.

With the October 1 deadline for the transition to ICD-10 fast approaching, it is imperative that billers are preparing themselves — and helping prepare their ambulatory surgery center — for this change. Failure to adequately prepare could lead to a dramatic increase in denied claims that impacts cash flow and drives an ASC's average number of days in accounts receivable up.

If you are unsure of the difference between ICD-9-CM and ICD-10-CM, here is a helpful comparison chart:

Item ICD-9-CM ICD-10-CM
Code Length 3–5 characters 3–7 characters
Number of Codes Approximately 14,000 codes Approximately 68,000 codes
Code Makeup Digit 1 = alpha or numeric
Digit 2-5 = numeric
Digit 1 = alpha
Digit 2 = numeric
Digit 3–7 = alpha or numeric
Expandability (space for new codes) Limited Flexible
Code Detail Vague Very specific
Code Examples E917.4
Striking against or struck accidentally by other stationary object without subsequent fall
W22.02XA
Walked into lamppost, initial encounter

There are many resources available to assist surgery centers in the transition, including an extensive list of free fact sheets, guides, timelines and checklists provided by CMS.

Several associations are publishing information on ICD-10 as well, including the following:

In addition, surgery centers can consider partnering with an ASC and physician medical billing solution like PGM Billing.

The ICD-10 deadline may seem like it is still far away, but ASCs and their business office personnel would be wise to start taking steps in preparation sooner than later. There is much to be done to ensure a smooth transition that keeps an ASC's revenue flowing.


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