Eight Ways ICD-9 Will Still Matter to Medical Practices

Some industry professionals believe we won’t need ICD-9-CM books after the October 1, 2014, implementation of ICD-10. That is simply not true.

Here are a few reasons you should keep your ICD-9-CM on the shelf:

• Think about all the claims that will need to be filed that weren’t entered into the billing system before the code set change. If you use ICD-10-CM codes on claims prior to October 1, 2014, the service will be denied.

• Think about the hospital stays that overlap from September 2014 to October 2014. Since ICD-10-CM is date-of-service driven, you will still need to access ICD-9-CM for a long time. Did you know you can either submit the services prior to October 1 with ICD-9-CM codes or wait until the patient is discharged to submit a hospital stay that began prior to October 1, 2014, and submit all dates with ICD-10-CM codes?

• Think about the claims that are denied or require further review. You will need to use your trusty ICD-9-CM book to determine if the most specific code was submitted the first time.

• Think about processing workers' compensation and third-party liability claims. Neither is required to convert to ICD-10-CM codes as the rest of the industry and will continue for an indefinite amount of time to use ICD-9-CM codes.

• Think about the continually updated tips and notes you’ve written in the margins, particularly as they relate to protocols you’ve learned in dealing with various payers.

• Think about reworking a service that was submitted to an incorrect payer. You may not know for months, or even a year, that a claim should have been submitted to a different payer.

• Think about simply getting one last ICD-9-CM book to handle all the aforementioned needs in the future because your current copy has several torn pages, is missing the cover, sports a handful of coffee mug stains, and/or was once accidentally dropped in a full bathtub (don’t ask).

• If you have one of the AAPC’s ICD-9-CM books, you will find enhanced resources in addition to the official government versions of volume one and volume two. You may rely on these helpful resources more than you realize:

     • Illustrations and clinically oriented definitions to aid in correct
        code assignment

     • Color coding, symbols, and footnotes which alert coders to coding and reimbursement issues

     • Additional digit-required symbols to ensure the most specific code is used

     • Indicators for the appropriate use of V-codes including sequencing order

     • Edits to codes which are age- or sex-specific

     • Definitions for many conditions which help determine the most specific diagnosis code

     • ICD-10-CM quick references for the most commonly reported ICD-9-CM codes

     • Alerts to properly use for manifestation codes, including when two codes are required and
         sequencing rules

     • Code alerts for "other specified" and "unspecified" codes

Don’t start ripping out pages from your ICD-9-CM book to use as fire kindling or to line the bottom of a birdcage. It makes sense to have a 2014 ICD-9-CM on hand, even after the transition to ICD-10.

Brenda Edwards, CPC, CPMA, CPC-I, CEMC, has been involved in many aspects of coding and billing since entering the profession more than 25 years ago. Her responsibilities at Kansas Medical Mutual Insurance Company include chart auditing, coding and compliance education, and contributing articles to the company’s website and publication. An AAPC-approved PMCC instructor, workshop presenter, and ICD-10 trainer, Edwards is a frequent speaker for local AAPC chapters in Kansas and Missouri and has presented at AAPC regional conferences. She currently serves as vice chair of the AAPC Chapter Association Board. E-mail her here.