Everyone has been gearing up in preparation of the October 1, 2014, ICD-10 implementation deadline. (Even CMS changed their claim form requirements: beginning on April 1, 2014, if you submit paper claims, you must use CMS1500 version 2/12 instead of version 8/05.) No one thought there would be another delay—that is, until Thursday, March 27, when the House of Representatives passed HR 4302, a bill that contained a provision to delay the implementation and extend the therapy cap and its exception process until 2015. Last Monday, the Senate also passed the bill and last Tuesday (April 1), President Obama signed it into law.

Even though ICD-10 has officially been delayed until October 1, 2015, we should still use this time to prepare. With that in mind, here’s my map to ICD-10:

  1. Plan your journey. Prepare a transition budget, build your ICD-10 team, and identify the most commonly used ICD-9 codes and their ICD-10 equivalents.
  2. Train your team. Find opportunities and resources to help your team prepare for the transition.
  3. Update your processes. Check your clinical documentation and update policies, procedures, systems, and forms.
  4. Engage your partners. Talk to your software vendors, clearinghouses, and billings services.
  5. Test your systems and processes. Test within your practice and with your partners.
  6. Follow up, audit, and monitor your progress. Ensure your codes are correct and that your documentation supports said codes. 

The ICD-10 manual is similar in organization to the ICD-9 manual; each chapter covers a different body system. As physical therapists, the chapters we’ll need to be most familiar with are:

  • Chapter 13: Diseases of the musculoskeletal system and connective tissue (6,339 codes)
  • Chapter 19: Injury, poisoning, and other consequences of external causes (39,869 codes)
  • Chapter 6: Diseases of the nervous system (591 codes)
  • Chapter 9: Diseases of the circulatory system (1,254 codes)
  • Chapter 10: Diseases of the respiratory system (336 codes)

Here are a few ways ICD-10 differs from ICD-9: 

  • ICD-10 contains laterality differentiators (right vs. left), which account for more than 40% of the codes.
  • ICD-10 codes have seven digits:
    • The first digit is always alpha; the second is always numeric.
    • The third through seventh digits can be either alpha or numeric.
    • There is a decimal after the third character.

Differences between ICD-10 and ICD-9

  • For an example, let’s consider codes for a meniscus tear, current, lateral:
    • Bucket-handle S83.25-
    • Complex S83.27-
    • Peripheral S83.26-
    • Specified type NEC 283.28-


How are you feeling about the transition to ICD-10? If you need any help, we’re here for you. PT Compliance Group is currently developing a list of commonly used ICD-9 diagnostic codes and their ICD-10 equivalents. We also can train the members of your team and perform audits to ensure you’re correctly using the codes and that your documentation supports their use.

Unwrapping MIPS and the Final Rule: How to Prepare for 2019 - Regular BannerUnwrapping MIPS and the Final Rule: How to Prepare for 2019 - Small Banner
  • ICD-10: Fact or Fiction Image

    articleApr 3, 2014 | 5 min. read

    ICD-10: Fact or Fiction

    As with any major change, the rumor mill churns at a mighty pace. With all the hearsay, telephone games, and disbursement of misinformation, it’s easy for the myths to swallow the truth. No worries, though; we’re here to sort the fact from the fiction. Fiction: Coders will spend an overwhelming amount of time dealing with external cause codes. Fact: From being struck by an orca to getting injured while crocheting, Chapter 20 of the ICD-10-CM Manual , …

  • The Complete PT Billing FAQ Image

    articleMay 24, 2016 | 25 min. read

    The Complete PT Billing FAQ

    Over the years, WebPT has a hosted a slew of billing webinars and published dozens of billing-related blog posts. And in that time, we’ve received our fair share of tricky questions. Now, in an effort to satisfy your curiosity, we’ve compiled all of our most common brain-busters into one epic FAQ. Don’t see your question? Ask it in the comments below. (And be sure to check out this separate PT billing FAQ we recently put together.) Questions …

  • Don’t Let ICD-10 and Direct Access Bug You Image

    articleAug 13, 2015 | 7 min. read

    Don’t Let ICD-10 and Direct Access Bug You

    Obviously, there’s been quite a buzz surrounding ICD-10; and providers throughout the country are making a tremendous effort to figure out exactly how the transition is going to affect us all . And just like a winged—and busy—bug that won’t stop whizzing past your ear, the noise isn’t likely to die down anytime soon. And that’s for good reason: the ICD-10 transition is a big one, and there are many factors rehab therapists have to consider when …

  • ICD-10 Open Forum Image

    webinarOct 5, 2015

    ICD-10 Open Forum

    On October 1, the US officially said RIP to ICD-9 and brought ICD-10 to life. For some of you, the transition might’ve been all sugar and spice—a real treat. But for many others, the switch to the new code set might’ve left you feeling overwhelmed, tricked, or even a bit scared. At the very least, you might be haunted by some lingering questions. That’s where we can help. We’ve brewed a cauldron filled to the brim with …

  • Dual-Coding Wonder Twin Powers: Activate? Image

    articleSep 2, 2015 | 3 min. read

    Dual-Coding Wonder Twin Powers: Activate?

    Thirty days has September—and so has your clinic to prepare for ICD-10. Just one month from now, you’ll have to start using ICD-10 codes on most claims with dates of service on or after October 1, 2015. Did you see I wrote, “most”? That’s not a typo. The reason I can’t say “all” is because not all payers are switching to ICD-10. That means you’ll have to be bi-code-lingual (so don’t purge your brain of all ICD-9 …

  • Dawn of the ICD-10: Life in the Post-Transition World Image

    articleOct 28, 2015 | 5 min. read

    Dawn of the ICD-10: Life in the Post-Transition World

    Some of you might remember all of the hype around Y2K. Rumors and speculation were abuzz, and there were people who thought all hell was going to break loose when the clock struck midnight on January 1, 2000. And then—dun, dun, dun—nothing happened. The Hyperbolic Hype The lead-up to October 1 was similar in many respects, albeit on a much smaller scale. People all over the healthcare community were freaking out about the unknown; some large practices …

  • The PT’s Guide to Surviving a Medicare Audit Image

    articleMay 30, 2016 | 5 min. read

    The PT’s Guide to Surviving a Medicare Audit

    “How can I avoid being audited by Medicare?” This is one of the compliance questions I hear most frequently, and the honest answer is, quite simply, that you can’t. Just because CMS or one of its auditing entities hasn’t come knocking on your door doesn’t mean you’re not being audited. In fact, every claim you submit undergoes statistical analysis, and Medicare compares your claims data to the data for all other claims submitted. Furthermore, Medicare now analyzes …

  • The Ultimate ICD-10 FAQ: Part Deux Image

    articleSep 24, 2015 | 16 min. read

    The Ultimate ICD-10 FAQ: Part Deux

    Just when we thought we’d gotten every ICD-10 question under the sun, we got, well, more questions. Like, a lot more. But, we take that as a good sign, because like a scrappy reporter trying to get to the bottom of a big story, our audience of blog readers and webinar attendees aren’t afraid to ask the tough questions—which means they’re serious about preparing themselves for the changes ahead. And we’re equally serious about providing them with …

  • ICD-10 Crash Course: Last-Minute Training for PTs, OTs, and SLPs Image

    webinarSep 2, 2015

    ICD-10 Crash Course: Last-Minute Training for PTs, OTs, and SLPs

    It’s officially here: the last month before all HIPAA-eligible professionals must switch to the ICD-10 code set. As the regret of procrastination washes over many of those professionals, they’re scrambling to ready themselves and their practices for the big switch. If you, like so many other rehab therapists, find yourself asking, “ICD-what?” then you’re in dire need of straightforward training—stat! Otherwise, you could leave your practice vulnerable to claim denials after October 1. Join us at 9:00 …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.