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Thursday, 26 December 2013 09:09

Physicians will Experience ICD-10 Anxiety Next Year. Should Dentists? Featured

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post 74 picThe implementation of ICD-10 codes will have a major impact on physicians and hospitals and an industry is sprouting up around preparing them for the 10/1/2014 start date. 

EHR Economics estimates that it will cost a small physician practice $83,000 to implement the new codes. 

But will it impact dentistry?  After some research, here are my conclusions.

The move to ICD-10 greatly increases the number of patient issues that may be described with a single code. 

There are approximately 13,000 ICD-9 codes, but version 10 gives us over 68,000.  Some of these codes border on the ridiculous. 

In preparing this post I ran across this list of actual ICD-10 codes.

ICD-10 Code Diagnosis
V9542XA Spacecraft crash injuring occupant
W5612XA Struck by a sea lion
V0001XD    Pedestrian in collision with roller-skater
Y92250 Injury in an Art Gallery
Y92146 Injury in a swimming pool of a prison
W6133XA    Pecked by a chicken

In November of 2012 I blogged that dental offices should prepare for a wider use of diagnosis codes.  I still think this is good advice.  Healthcare is headed toward more extensive sharing of information between care settings and the diagnosis code will become a key element to be shared. 

In October of next year the ICD-10 will become the lingua franca of diagnoses.  If a physician shares the medical history of a patient, expect to see these codes and be able to adjust your dental treatment according to what they are telling you.

But will you be using ICD-10’s to describe your services? 

A look at the ADA’s 2012 dental claim form shows blocks “34” and “34a”, diagnosis codes and diagnosis code qualifiers.  The form is ready both in its paper and electronic format.  When do you use these two blocks and when can they be left blank?  The phrase “required situationally” appears regularly in articles that speak to this.  

What are these situations that would require the code?  This depends on the patient’s insurance company.  Many dental payers offer increased benefits for services associated with certain systemic conditions. 

The increased benefit could include additional services or increased frequency in provided treatment. 

Here is a page from our parent company’s website about just such a program.  In order to access these benefits with a minimum of effort, having the appropriate diagnosis code on the claim will grease the wheels.  Insurers may also allot increased benefits for complex services.  

The ICD-10 code implementation will not have the impact on dentistry that it does on the medical side of healthcare but you will need to be familiar with the ICD codes in both their 9th and 10th iterations. 

Watch for insurer’s programs that allow increased benefits for certain conditions and be sure you utilize these for the applicable patients. 

Using the ICD blocks on the 2012 claim from will allow you to easily communicate this to the insurance company.  

Familiarity with the new codes will allow you to better prepare for that patient whose health history says they suffer from R46.0, very low level of personal hygiene. 

Preparation for this diagnosis would be a definite right click for you and the rest of your staff.

Read 9136 times Last modified on Thursday, 26 December 2013 09:35
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