About ICD-10-CM for Audiology and Speech-Language Pathology
International Classification of Diseases, 10th Revision, Clinical Modification
Note: On April 1, 2014, President Obama signed into law the Protecting Access to Medicare Act of 2014. This law included a provision that delays the implementation of ICD-10 from October 1, 2014 to October 1, 2015.
Beginning October 1, 2015, health care providers will be required to use the new ICD-10 system, which will replace the current ICD-9 (International Classification of Diseases, 9th Revision) Volumes 1, 2, and 3 used to report health care diagnoses, disorders, and inpatient hospital procedures.
The codes in ICD-10 are not valid for any purpose or use in the United States until October 1, 2015.
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ICD-10 will replace ICD-9 as the official system of assigning codes to diagnoses and procedures associated with hospital utilization in the United States. The ICD is also used to code and classify mortality data from death certificates.
The new ICD-10 will include the ICD-10-CM (clinical modification) and ICD-10-PCS (procedure coding system). The ICD-10 is owned by the World Health Organization (WHO). The clinical modification was developed by the Centers for Disease Control and Prevention for use in all U.S. health care treatment settings. The procedure coding system (i.e., ICD-9-PCS and ICD-10-PCS) was developed by the Centers for Medicare and Medicaid Services for use in the U.S. for inpatient hospital settings only. ASHA's resources focus only on ICD-10-CM.
The intent of ICD-10-CM is to standardize disease and procedure classification throughout the United States and to gather data about basic health statistics.
HIPAA legislation requires the ICD-10-CM to be used for health services billing and record keeping. As noted above, the effective implementation date for ICD-10-CM (and ICD-10-PCS) is October 1, 2015. Updates to the current version of ICD-10-CM are anticipated prior to its implementation.
Relation to Professional Scope of Practice
The audiologist or speech-language pathologist practicing in a health care setting, especially a hospital, may have to code delivery of services according to the ICD-10-CM.
Why the Switch?
The Centers for Disease Control and Prevention (CDC) developed the new ICD-10-CM classification system because the ICD-9-CM is running out of codes. Hundreds of new diagnosis codes are submitted annually. The ICD-9-CM is 30 years old, has outdated and obsolete terminology, and produces limited data. ICD-10-CM will allow for more codes and greater specificity and thus better data tracking of incidence and prevalence of disease.
The ICD-10 is owned by the World Health Organization (WHO) and ICD-10-CM is the United States' modification of the ICD-10.
Differences Between ICD-9-CM and ICD-10-CM
The ICD-10-CM codes are based on an alpha-numeric system that is very different from the current ICD-9-CM numeric-only system. ICD-9-CM consists of approximately 13,000 codes while ICD-10-CM has approximately 68,000 available codes and provides more flexibility for adding new codes. ICD-9 lacks detail whereas ICD-10 is very specific. This may mean a decreased need to include supporting documentation with claims. ICD-10 will provide better data for processing claims, making clinical decisions, tracking public health, conducting research, and identifying fraud and abuse. Additionally, conditions have been grouped in a more logical fashion than in ICD-9. This may have been accomplished by means of movement from one chapter to another or one section to another. Many codes have been added to, deleted from, combined, or moved in ICD-10.
ICD-10 codes are three to seven characters in length. The first character is alpha, the second is numeric, and the third through seventh characters are either alpha or numeric. Valid codes can have anywhere from three to seven digits.
Examples of ICD-9-CM vs. ICD-10-CM Codes
||H91.10 Presbycusis, unspecified ear
||H91.11 Presbycusis, right ear
||H91.12 Presbycusis, left ear
||H91.13 Presbycusis, bilateral
||R47.1 Dysarthria and anarthria
Official ICD-10-CM Resources