ONE: High-level differences

The table below illustrates nine high-level difference between ICD-9 and ICD-10 for quick reference (click to enlarge).

Two: External cause code reporting

Reporting of ICD-10 codes in Chapter 20, External Causes of Morbidity, is not required, unless a provider is subject to a state-based external cause code reporting mandate or these codes are required by a particular payer.

However, in the absence of a mandatory reporting requirement, providers are encouraged to voluntarily report external cause codes, as they provide valuable data for injury research and evaluation of injury prevention strategies.

If your exam is due to external causes, you may want to have the what, when, where and how it happened documented. Below is an example of how you would code a closed fracture of right ankle due to fall from jungle gym at the park in ICD-9 vs. ICD-10.

ICD-9 codes:

  • 824.8 – Fracture of ankle, closed
  • E884.0 – Accidental fall from playground equipment

ICD-10 codes:

  • S82.51xA – Closed fracture, right ankle
  • Y93.39 – Involving climbing
  • W09.2xxA – Fall, jungle gym
  • Y92.830 – In the park

THREE: “V” codes for ICD-9 are “Z” codes for ICD-10

Z codes are not used for injury or trauma, but they are used for follow-up and aftercare visits. Here are a few examples of Z codes you might use:

  • Z00.00 – General adult medical exam without abnormal findings
  • Z00.01 – General adult medical exam with abnormal findings
  • Z00.110 – Health exam for newborn < 8 days old
  • Z00.111 – Health exam for newborn 8-28 days old
  • Z00.121 – Routine child health exam with abnormal findings
  • Z00.129 – Routine child health exam without abnormal findings

FOUR: Billing — HCFA 1500 Claim Form Difference

  • Old 1500 claim form: There is a maximum of 4 diagnosis code fields labeled 1 to 4 in Box 21
  • New 1500 claim form: There is now a maximum of 12 diagnosis code fields labeled A to L in Box 21

Education and preparation will be the key to your practice’s smooth transition to using the new ICD-10 codes, so start today! Stay tuned into our ICD-10 series to learn more about preparing for the transition.

Interested in learning more about how to prepare for the transition? Click one of the links below to view the other posts in our ICD-10 series!

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