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.