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:
- American Health Information Management Association (AHIMA)
- American Association of Professional Coders (AAPC)
- World Health Organization Electronic ICD-10 Training Tool
- Centers for Disease Control and Prevention
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.