ICD-10: Getting Ready
Melody W. Mulaik, MSHS, CPC, CPC-H, RCC, PCS, FCS
This new column will focus on ICD- 10
information and implementation preparation specifically for radiology administrators. The goal is for this information to
prove useful and valuable to individuals
responsible for overseeing this critical
Currently, both physicians and hospitals utilize ICD-9-CM codes to report diagnosis information to third party payors.
These codes indicate a radiologist’s definitive findings or symptoms, conditions, problems, complaints, or other reason for the
radiological service. Many insurance payors utilize this information to establish
medical necessity by indicating the nature
and severity of the condition.
There are many problems with the current ICD-9-CM codes. They do not consistently describe twenty first century care
since many of the disease categories are full
and there is no additional room to place
more descriptive codes. The current codes
do not provide sufficient details on a
patient’s medical condition. Additionally,
the current codes contain outdated and
obsolete terminology. These problems produce inaccurate and limited data. The current ICD-9-CM system is over 30 years old
and was never designed for use in healthcare reimbursement.
Effective October 1, 2013 all healthcare
providers must begin using ICD-10-CM
on submitted claims. According to the
Centers for Medicare and Medicaid Ser-
vices (CMS), ICD-9-CM codes are not
valid for dates of services on or after Octo-
ber 1, 2013. It is important to note that the
United States is the last major nation to
adopt ICD- 10.
The majority of the hospital planning for
ICD- 10 will be outside of the control of
radiology. Radiology administration should
get involved where possible to ensure that
the department is properly represented.
The areas of concern that are unique to
the department of radiology should be
identified so they may be addressed at
the appropriate time. Examples could
include educating technologists on key
components of ICD- 10, educating the
radiologists on their dictations, and even
educating referring physicians on completeness of orders to ensure proper ICD-
10 code assignment.
It is important to point out that the
biggest changes will occur in computer
systems. Much programming will occur
behind the scenes and it is key that all radi-
ology systems be taken into account when
resources are allocated. For example, does
your radiology information system (RIS)
interact with the facility’s electronic health
and/or medical record (EHR/EMR)? What
specific data is shared between the sys-
tems? How is it used?
Melody W. Mulaik is president and co-founder of
Coding Strategies, Inc. She is a nationally recognized
speaker and has delivered numerous presentations at
AHRA annual meetings and conferences. Mulaik is a
member of AHRA, has published extensively, and may be
contacted at email@example.com.