Icd 10 Changes to Diagnostic and Inpatient Procedures

¶ … Clinical Staff of Nightingale Home Care Inc.

There will be significant changes within the organization as we embrace changes set by the American Medical Association. As RN's and LVN's, we are responsible for adapting to the internal policy changes that are required as a result of the introduction to ICD-10 beginning in October of 2015. The ICD-10 has a new set of diagnostic codes that will replace the ICD-9 codes in "medical diagnoses and inpatient procedures" (Center for Medicare & Medicaid Services, 2015). Many believed that the ICD-9 codes were outdated and limited how health care staff could describe and interpret health care data regarding diagnoses and inpatient procedures (Center for Medicare & Medicaid Services, 2015). As such, this new system provides room for greater specification that will help streamline inpatient procedures within the facility.

Nightingale Home Care Inc. will be affected in a number of ways based on its structure as a home related health agency. Internal policy changes will include changes in how Medicare and Medicaid claims are handled. Medicare will no longer accept ICD-9 codes, and thus the facility staff must be up-to-date with the new ICD-10 coding system. Valid ICD-10 codes are "composed of codes with 3, 4, 5, 6, or 7 characters" that will be used to code for diagnostic descriptions (American Medical Association, 2015). Codes containing only three characters will need further subdivision in order to properly address the specifics of the diagnosis. Five character codes will be required by this facility in order to avoid issues in misunderstanding or misclassifying diagnoses. These three letter codes are considered family codes, and must be described further in order to prevent later issues with the claims. Five character codes are much more specific and provide enough information to avoid an audit from Medicare. For example, the use of C81, for Hodgkin's lymphoma, needs to be classified further with additional coding characters, such as c81.00 (nodular lymphocyte predominante Hodgkin lymphoma, unspecified site) or C81.03 (nodular lymphocyte predominante Hodgkin lymphoma, intra-abdominal site), as reported by the American Medical Association (2015). These new codes have been updated, making it easier for a modern interpretation of diagnosis and patient procedures, as they include new procedures that have been implemented in the past thirty years since the launch of the ICD-9. Moreover, "it enables reporting of laterality (right vs. left designations), reflecting the important of which side of the body or limb (e.g., left arm, left kidney, left eye) is the subject of the evaluation," which greatly increases the descriptive possibilities for diagnostic and inpatient procedure reporting (). Such changes impact both diagnostic and inpatient procedure purposes.

The new codes vary depending on their use. There will ultimately be a huge impact on nursing procedures, as diagnosis procedures will change within the adaption of new diagnostic codes. In terms of diagnostic codes, the procedure of inputting diagnoses is changing, as the new ICD-10 coding requires the use of three to seven digits, rather than the previous use of three to five. This helps specify diagnoses even further and allows for more description than what was possible in the ICD-9 system. The overall code set is similar, but there are changes to the descriptive codes that correspond with the broader family codes, as described previously with the use of Hodgkin lymphoma examples.