Major Changes in Health Information Coding Practice and Implications for Cancer Surveillance Jennifer Ruhl RHIT CCS CTR NCI SEER Steve Peace BS CTR Univ of Miami Overview ICD9CM coding resources ID: 934420
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ICD-9-CM and ICD-10 Updates and U.S. Adoption of ICD-10-CM Coding Standard: Major Changes in Health Information Coding Practice and Implications for Cancer Surveillance
Jennifer Ruhl, RHIT, CCS, CTR (NCI SEER)
Steve Peace, BS, CTR (Univ. of Miami)
Slide2OverviewICD-9-(CM) coding resourcesICD-10 coding resourcesIntroduction of ICD-10-CM
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Slide3ICD-9-(CM) and ICD-10Uses of medical coding systems for cancer registrars:Casefinding
Case matching
Record & tumor linkage
Death certificate coding
Follow up and treatment
Special studies
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Slide4Updates to ICD-9-CM/ICD-10ICD-9-CM: Bi-annual updatesMinor update AprilMajor update OctoberICD-10
Scheduled for every three years
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Slide5Cancer Registry Sources using ICD-9-CM/ICD-10ICD-9-CM casefinding listICD-9-(CM) to ICD-10
ICD-10 to ICD-9-(CM)
ICD-O-3 to ICD-9-(CM)
ICD-O-3 to ICD-10
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Slide6ICD-9-CM Casefinding listUpdated in 2009 and 2010 and includes:
neoplasm codes (malignant, in-situ, benign, borderline)
cancer related diseases
personal history codes
Reviewed by SEER registries
Reviewed by representatives from AJCC
CoC
and NPCR CDC
Next update due January 1, 2011
http://www.seer.cancer.gov/tools/casefinding/index.html
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Slide7ICD-9-(CM) to ICD-10 andICD-10 to ICD-9-(CM)Major update 2009-2010Incorporated all coding changes since last update (mid 1990s)
Will be posted to SEER website August 2010
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Slide8ICD-9-CM to ICD-10 andICD-10 to ICD-9-CMBased on 2010 ICD-9-CM Casefinding list
All codes from
casefinding
list are represented
General Equivalency Mappings (GEMs) used to update
GEMs provided by CMS
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Slide9What are the GEMS?Developed by CMS as a tool to assist with the conversion of ICD-9-CM to ICD-10-CMIncludes:One to one mapping
One to many mapping
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Slide10What are the GEMS, cont.Intended audiences include:Coding professionalsPayers/Providers
Medical researcher
Use of GEMS
Converting payment system
Payment and coverage edits
Quality measures
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Slide11ICD-9-CM to ICD-10 andICD-10 to ICD-9-CMFile layout:Type of Code
Reportable
Supplemental
ICD-9/10 Category Code
ICD-9/10 Term (code description)
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Slide12ICD-9-CM to ICD-10 andICD-10 to ICD-9-CMAdditional reviewers included:
SEER Cancer Registries
Leah Driscoll, CTR (Kentucky)
Frances Ross, BA, CTR (Kentucky)
Westat
(Rockville, MD)
Mary Mesnard, BS, RHIA, CTR
Annette Stephens, BA, BS, RHIA
IMS (Silver Spring, MD)
Rashid
Aminou
, MS
Nicki
Schussler, BS
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Slide13Our ICD-9-CM/ICD-10 ExpertsICD-9-CMAmy Blum, MHSA, RHIA, CTRMedical Systems Specialist, National Center for Health Statistics (NCHS)
ICD-10
Carolyn Watkins
Certified
Nosologist
Kenneth D.
Kochanek
, Statistician
Mortality Statistics Branch, National Center for Health Statistics (NCHS)
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Slide14Upcoming projects:ICD-10 COD Casefinding listRelease date July 2010
ICD-O-3* to ICD-9-(CM)
Scheduled completion: 2011
ICD-O-3* to ICD-10
Scheduled completion: 2011
*Includes new Hematopoietic codes
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Slide15ICD-10-CMU.S. implementation October 1, 2013Based on ICD-10Alphanumeric codesMajor changes include:
Laterality coding
New code categories
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Slide16ICD-9-CM vs. ICD-10-CMICD-9-CM Numerically based30 year old coding system
Running out of room for new codes (currently about 11,000 codes)
ICD-10-CM
Alphanumerically based
Less than 20 year old coding system
Ample room for expansion (currently greater than 60,000+ codes)
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Slide17ICD-9-CM vs. ICD-10-CMICD-9-CMLimited specificity (only up to 5 digit codes)Using 30 year old medical terminology
Laterality not included for applicable cancer codes
ICD-10-CM
Greater specificity (up to 7 digit codes)
Updated to current medical terminology
Laterality included for applicable cancer codes
Provides codes for many conditions not included in ICD-9-CM
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Slide18Example: Breast, unspecified siteICD-9-CM code: 174.9ICD-10 code: C50.9ICD-10-CM codes:
C50.911: unspecified right female
C50.912: unspecified left female
C50.919: unspecified side female
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Slide19Example: Low grade MDSICD-9-CM code: 238.72ICD-10 code: D46.7ICD-10-CM codes:D46.a Refractory
cytopenia
with
multilineage
dysplasia
D46.b Refractory
cytopenia
with
multilineage dysplasia and ringed sideroblasts
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Slide20ICD-10-CMPreparing the Cancer Registry fieldCommittee to be formed representing all the Cancer Registry field standard settersGoal of committee to determine best way to educate cancer registrars about ICD-10-CM
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Slide21ICD-10-CM ResourcesICD-10-CM casefinding listPlanned first appearance is January 1, 2013, in conjunction with 2013 ICD-9-CM
casefinding
list
ICD-9-CM to ICD-10-CM
ICD-10-CM to ICD-10
ICD-O-3 to ICD-10-CM
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Slide22ICD-10-PCSReplacing outdated coding system for procedure codesAlphanumeric codesUp to 7 digit longCodes “developed” through table selection process
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Slide23ResourcesICD-10-CM (CMS website)http://www.cms.gov/ICD10/12_2010_ICD_10_CM.aspICD-10-PCS (CMS website)
http://www.cms.gov/ICD10/13_2010_ICD10PCS.asp#TopOfPage
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Slide24ConclusionICD-9-CM and ICD-10 resources published by SEER undergoing major updatesPlanning for ICD-10-CM
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