ICD-1O Informational Series, Part IV: Example of Coding Changes
January 31, 2014
As a result of feedback from MaineCare’s Provider Readiness survey participants, we have developed an ICD-10 Informational Series for providers in order to share information and to direct you towards preparing for transitioning from ICD-9 to ICD-10.
The informational series will include the following parts or topics:
Part I: Overview of Provider Survey Results
Part II: MaineCare’s Provider Outreach Plan
Part III: ICD-10 Provider Impact
Part IV: Example of Coding Changes
Part V: Provider Preparation/Helpful Hints
Provider Readiness Survey results indicated that providers would benefit from understanding how ICD-10 is different from ICD-9. As a result, MaineCare would like to share the information below, which describes some of the changes in ICD-10. For more detailed information, please see the resources listed at the bottom of this message.
How are ICD-10 codes different from ICD-9 codes?
Longer codes: ICD-9 codes are 3-5 characters, while ICD-10 codes can be up to 7 characters.
- Providers need to make sure their systems, processes, and forms can accept the new, longer codes.
More granular: ICD-10 codes are far more granular than ICD-9 codes and provide much more specific information.
The greater specificity of ICD-10 means that one ICD-9 code can be represented by multiple ICD-10 codes.
Providers need to determine which ICD-10 codes to use in place of ICD-9 codes.
The following example shows how one ICD-9 code can be represented by multiple ICD-10 codes:
996.71 Other complications due to heart valve prosthesis
T82.817A Embolism of cardiac prosthetic devices, implants and grafts, initial encounter
T82.827A Fibrosis of cardiac prosthetic devices, implants and grafts, initial encounter
T82.837A Hemorrhage of cardiac prosthetic devices, implants and grafts, initial encounter
T82.847A Pain from cardiac prosthetic devices, implants and grafts, initial encounter
Centers for Medicaid and Medicare Services (CMS) has provided a tool, called General Equivalence Mappings (GEMs) that can assist providers with determining which ICD-10 codes to use. You can access GEMS on the CMS website.