ICD 10s are actually here! Blog Feature
Melissa Outlaw

By: Melissa Outlaw on October 26th, 2015

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ICD 10s are actually here!

Healthcare Provider Credentialing

This month at the NAMSS conference, a medical staff professional, Chip, reminded me of a blog that I wrote a couple of years ago about 10 codes. For those of you who missed it or for those of you that could use a little humor, here it is for a second time!

Provider Privileging

Search the internet for the terms 'funny' and 'icd 10 codes' and it is amazing how many results are returned. There is article after article, cartoon after cartoon, and at least one parody depicting all the odd and unique codes that will probably never be used in the United States. These funny codes describe incidents with turtles, water skis on fire, and even Senator Rand Paul rants about codes involving macaws? So why are we being asked or forced (depending on your perspective) to spend thousands of dollars to convert from the '9s' that have worked fine for this long?

 ICD Origin

Let's start at the beginning, ICD stands for International Classification of Diseases and was created by the World Health Organization (WHO). The important things to note are the words International and World. Point being, ICDs were created for everyone not just those in the US; hence codes that cover macaw attacks. The Centers for Medicare and Medicaid (CMS) along with the National Center for Health Statistics (NCHS) reviewed the ICD 10s and modified them to include diagnoses and visit reasons for American healthcare; called ICD-10-CM (Clinical Modification).

CMS reveals the benefits of ICD-10-CM?

In April of 2013, CMS released a quick reference guide/fact sheet1 and states that utilizing ICD-10-CM "will provide much better data for: 

  • Measuring the quality, safety, and efficacy of care;
  • Reducing the need for attachments to explain the patient’s condition;
  • Designing payment systems and processing claims for reimbursement;
  • Conducting research, epidemiological studies, and clinical trials;
  • Setting health policy;
  • Operational and strategic planning;
  • Designing health care delivery systems;
  • Monitoring resource use;
  • Improving clinical, financial, and administrative performance;
  • Preventing and detecting health care fraud and abuse; and
  • Tracking public health and risks."

Benefits to your organization

It may seem overwhelming to convert from 18,000 to over 140,000 codes, but sometimes more is better!  Think of it as being told that the restaurant you are looking for is on 85th Street in NYC, but aren't told whether it’s 85th Street East or West.  Having all the details, whether it is the correct address for a restaurant or precise medical information could make a huge difference.  Besides, walking the extra distance from East to West may result in ICD-10 code W22.02XA (walked into lamp-post initial encounter).

1 Centers for Medicare and Medicaid and Medicare Learning Network: http://www.cms.gov/Medicare/Coding/ICD10/downloads/ICD-10QuickRefer.pdf

Provider Credentialing



About Melissa Outlaw

Melissa Outlaw is a Vice President, Customer Success with symplr. Melissa and her team assist clients in learning and implementing our provider management software - credentialing, privileging, peer review, quality and event reporting applications. She supports clients in benchmarking current internal practices, identifying potential efficiencies, then driving the integration of technology with process improvement to reduce time of service and operating expenses. She works extensively with decentralized, multi-facility organizations in transitioning to a shared service center as well as assisting healthcare organizations bridge the gap between procedures performed by a provider and their privileges granted.