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Symposium on ICD-Conversion – February 2012

Tex Med. 2012;108(2):24. 

By Larry BeSaw

Texas Medicine is proud to have published numerous special symposium issues on topics that are vital to physicians and their patients over the past several years, but this one may be our most important symposium yet.

That's because on Oct. 1, 2013, the way you practice medicine will fundamentally change. That is the day all physicians must begin using the International Statistical Classification of Diseases and Related Health Problems (ICD)-10 to record all diagnoses and inpatient procedures. Mandated by the U.S. Department of Health and Human Services, the upgrade from ICD-9 will enable doctors' offices to collect and exchange more-detailed patient data.

As Austin freelance writers Liz Carmack and Katie Ford explain in the lead story, the change is the most challenging initiative since the inception of medical coding. The number of diagnostic codes under ICD-10-CM will grow from 13,500 to 69,000. The number of codes for inpatient procedures under ICD-10-PCS will soar from 4,000 to 71,000. For example, there are nine potential location codes for pressure ulcers under ICD-9-CM, while ICD-10-CM has some 125 codes. The ICD-9 codes show broad location but not depth, whereas the ICD-10 codes show specific location as well as depth.

Tyler family physician and American Academy of Professional Coders National Advisory Board member Stephen Spain, MD, says the transition to ICD-10 involves more than learning a new code set and upgrading your software. It will affect every aspect of your practice. "I think physicians will be surprised at how pervasive the changes will be, and how much it is going to affect their work flow," Dr. Spain says in our lead story.

Prepared under the direction of the physicians on the Texas Medicine Editorial Board, this special issue of Texas Medicine explains what you need to know about the transition to ICD-10 and what you need to do to prepare. It also offers 1 hour of continuing medical education credit for reading the articles, taking a short quiz, and returning the CME Evaluation Form.

In addition to the lead story by Ms. Carmack and Ms. Ford, Texas Medicine Senior Editor Ken Ortolon offers a primer on ICD-10 and the benefits and headaches that come with it; Associate Editor Crystal Conde details how TMA can help your practice make the switch; and Ms. Carmack explains what the Medicare and Medicaid programs and the major private insurance companies are doing to get ready for ICD-10. Finally, Heather Bettridge, TMA Practice Consulting practice management consultant, debunks the eight most common myths about ICD-10. For instance, it is not true that a practice must use electronic medical records to use ICD-10 codes. All medical practices, whether maintaining paper or electronic medical records, will be required to use ICD-10 codes.

We hope you find this symposium issue helpful. I would like to thank the writers for their explanation of the new coding system and what it means to physicians. I also want to thank Houston otolaryngologist Charles Stiernberg, MD, a member of the TMA Council on Health Care Quality and a former chair of the TMA Council on Practice Management Services, for his guidance. Finally, thank you to TMA Practice Consulting Director Peggy Pringle and TMA Payment Advocacy Department Director Genevieve Davis and their staffs for their technical expertise. We could not have prepared this issue without them. 

Larry BeSaw is editor of Texas Medicine.

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