In a few years, providers will be dealing with some 68,000 codes. Plan now to protect your bottom line.

Gearing up for ICD-10-CM im-plementation will take much more planning than just a simple yearly update. Many considerations come into play and implementation may take several years to accomplish.

On January 16, 2009, the US Department of Health and Human Services (HHS) published an October 1, 2013, implementation date of the 10th revision of the International Classification of Diseases (ICD-10). While the change of date to October 1, 2013, from October 1, 2011, published in the notice of proposed rulemaking may afford more time to prepare for the transition, it still represents an aggressive time frame. Providers?imaging facilities included?must act now for a successful transition from ICD-9-CM to ICD-10-CM.

Prior to being able to implement the ICD-10 code sets, you must successfully implement 5010. This is required to be done by January 1, 2012. The Secretary of HHS adopted version 5010 to replace the current version of the X12 standard that covered entities (health plans, health care clearinghouses, and certain health care providers) must use when conducting electronic transactions including: claims (professional, institutional, and dental), claims status requests and responses, payment to providers, eligibility requests and responses, referral requests and responses, enrollment and disenrollment in a health plan, Coordination of Benefits, and premium payments. Once you have addressed 5010 with your vendors, you must also ascertain whether your current software systems can handle the changes in data.

Your preparation must include information on the length of characters necessary for ICD-10-CM and ICD-10-PCS codes. Prepare not only for the extra digits but also to include alphanumeric entries. Concerns to share with IT on this area are:

  • Character case-sensitivity;
  • Placement of decimals for reporting;
  • Increasing number of codes; can system handle;
  • Can both ICD-9 and ICD-10 be supported during transitional times.

Make sure that IT performs a comprehensive review of systems for audit for ICD-10 implementation by inventorying all of your databases, giving special considerations to implementation hurdles such as:

  • How to accommodate mapping if possible;
  • Stopping assignment of ICD-9 codes from being used after implementation;
  • How interfaces will work between coding conventions;
  • Timelines for testing of system.

Now, during the planning period, is the time to determine if your current system can handle the required software changes so that budgets can be determined and the search for a new vendor can be accomplished if necessary. Waiting to address these issues could very well hinder implementation, causing cash flow issues in the practice.

See the chart for a glimpse of the changes you will encounter going from ICD-9-CM to ICD-10-CM.

As you can see, there are big changes to formatting and how specific the codes are. Documentation will be a key concern and should be addressed early in the implementation period. Because ICD-10 includes laterality, and also stages of healing, providers must be sure to document key elements. Radiology providers in particular must be concerned with episodes of care, along with laterality and any stages of healing, as these were not addressed in ICD-9-CM.

Look to trusted resources for your ICD-10 trainings. There will be many venues available for both implementation training and code set training such as on-site training, workshops, webinars, and regional and national conferences. For more information on ICD-10, visit the AAPC Web site at

If particular attention to the implementation process is not followed, practices will find themselves facing hurdles including loss of reimbursements or denied or delayed claims. The time to plan for ICD-10 is now!

Rhonda Buckholtz, CPC, CPC-I, CGSC, CPEDC, COBGC, CENTC, is vice president of business and member development, American Academy of Professional Coders (AAPC,