Presented by
Regina Glenn, PhD., RHIA, CCS
Davenport University
◦ ICD-9-CM is over 30 years old
 Outdated
 Lacking necessary detail to describe
conditions and/or procedures performed
 Not compatible with current medical care
 Contains obsolete terminology
 Missing current terminology
 Results in limited data collection
◦ Think about it –
 How much has health care changed in
the past 30 years?
 How much has the delivery in health care
changed in the past 30 years?
 How can a system that is 30 years old
reflect current medical practices?
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ICD-10-CM is a diagnostic classification
system that was developed by the CDC for
use in the United States.
It will replace ICD-9-CM Volumes I and II

ICD-10-CM will replace the use of ICD-9-CM
to report diseases, injuries, impairments,
other health problems, and the causes of
those diseases and injuries in ALL healthcare
settings.
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ICD-10-PCS will replace the use of ICD-9-CM
to report procedures and treatments on
hospital inpatients only.
CPT/HCPCS will continue to be use in the
outpatient settings to report procedures,
treatments and services provided.
Numeric or Alpha
(E or V)
V
X
E
4
5
Numeric
X
1
Category
X
4
.
X
0
X
0
Etiology, anatomic
site, manifestation
3 – 5 Characters
8
2 - 7 Numeric or Alpha
Alpha
(Except U)
M
A
X X
S
3 X
2
Category
.
Additional
Characters
X
0 X
1 X
0
A
X
Added code
extensions (7th
character) for
obstetrics, injuries,
and external causes
of injury
Etiology, anatomic
site, severity
3 – 7 Characters
9
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Example: Multiple Sclerosis
◦ Current ICD-9-CM
 340
◦ ICD-10-CM
 G35
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Codes begin with a letter
Characters 2 through 7 may be either a
letter or a number
Uses extensions
◦
◦
◦
◦
Provides additional about the condition
7th character
May be either a letter or a number
Used most often with injury codes
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Uses placeholders
◦ Always the letter “X”
◦ Used when the code has less the 6 characters and a
7th character extension is required.
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Code groupings
◦ More logical grouping of codes based on
current medical knowledge
◦ Some codes have been reassigned to
different chapters
◦ Injuries grouped by site instead of type of
injury

Complete descriptions
◦ Complete subcategory titles
◦ All characters are listed within the code.
Additional characters are no longer
located at the beginning of a chapter,
section or category

Laterality
◦ Incorporates laterality (right, left, bilateral)
into code descriptions

Specificity
◦ Expanded detail

Combination codes
◦ Groups etiology and manifestation
◦ ICD-9-CM usually requires two codes
◦ Poisonings and external causes
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Terminology used
◦ Reflect current medical knowledge

Postprocedural
◦ Indentifies the difference between
postoperative and postprocedural
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Trimester specificity
◦ Pregnancy, delivery and puerperium codes
include identification of trimester
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Punctuation
◦ Square Brackets
 Synonyms, alternative wording or
explanatory phases
◦ Parentheses
 Nonessential modifiers, optional
descriptions
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Code first
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Use additional code
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Code also
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Includes

Has two excludes notes
◦ Excludes 1 means not coded here – the
code is excluded and should never be
coded at the same time
◦ Excludes 2 mean not included here – the
code is excluded and can be used at the
same time

Coding Clinics
◦ Were designed and written for use with
ICD-9-CM
◦ Will not longer be valid with ICD-10-CM.
◦ New coding clinics will be written for ICD10-CM
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Read
Ask questions
Talk with others
http://www.youtube.com/watch?v=LihXPo6iF
xI&feature=related
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AHIMA (2010) ICD-10-CM Coding Guidelines:
An Overview Audio Seminar
Barta, A., DeVault, K. & Zeisset, A.. (2010)
ICD-10-CM/PCS Academy Coder Training
Manual – Instructor’s Edition. AHIMA Press
Hazelwood, A. & Venavle, C.A. (2009).
ICD-10-CM and ICD-10-PCS Preview.
AHIMA Press