After several delays, the United States is ready to catch up with the rest of the world. On October 1, the country is set to begin using the World Health Organization’s updated diagnostic codes. And, by most accounts, psychologists seem ready for the change.
The ICD-10, which was originally released in 1994, was adopted by nearly all industrialized countries quickly with the U.S. being the only major holdout because of issues with our more complex system.
According to the CDC Web site, “ICD-10 will affect diagnosis and inpatient procedure coding for everyone covered by the Health Insurance Portability and Accountability Act (HIPAA), not just those who submit Medicare or Medicaid claims. The change to ICD-10 does not affect CPT coding for outpatient procedures.”
When the new system goes into effect on October 1, practitioners will need to begin using the new alpha-numeric codes rather than the previous all-numeric codes. ICD-10-CM contains far more codes, up to 68,000 from 14,000, in order to increase the specificity of diagnoses and to track health concerns globally. Medical practitioners will bear the brunt of the coding changes.
“For psychologists,” said Lynn Bufka, aassistant executive director of practice research and policy at the American Psychological Association, “the biggest change will be with substance abuse codes where there will be a larger number of codes so that diagnoses can be more specific. Beyond that, the codes will not be radically different conceptually.”
There are a number of online resources to help identify the correct codes, said Bufka. With some, a practitioner can plug in the old number and get a link to the new number or numbers that would correlate.
“There is a web-based app that APA/APO members have access to where you can type in different key words and it will bring up all of the codes that contain those words,” said Bufka. “I also like ICD-9data.com and ICD-10data.com.”
Bufka recommends that psychologists update the coding regularly as the CDC will make changes as needed. In addition, the ICD-11 codes are scheduled to be released in 2017 and the CDC may release updates intermittently to transfer to the newer codes more quickly.
Another recommendation? Keep all billing up to date to avoid confusion. All service done after October 1 would need to use the new codes but treatment administered before
that date would still use older codes.
For the most part, local psychological associations have not seen much concern from membership about the impending changeover. Perhaps because of the double delay, more psychologists may be aware of the codes and how it will affect them.
“Our membership tends to be pretty quiet, so it is difficult to speak to whether they are prepared for the change,” said Traci Cipriano, JD, Ph.D, director of professional affairs for the Connecticut Psychological Association (CPA), “Because of the accessibility of information, I do not expect the transition to be difficult for most psychologists, particularly if they participate in a training.”
CPA is looking to put on an ICD workshop in late summer and will send out more information in its e-news.
“I have not heard of any problems with the implementation of ICD-10-CM,” said Michael Goldberg, Ph.D., director of professional affairs and past-president of the Massachusetts Psychological Association (MPA).
Goldberg recommends that MPA membership take advantage of resources including those released by the CDC (ICD-10-CM Tabular List of Diseases and Injuries) and the APA’s “A Primer for ICD-10-CM Users,” which contains all of the codes related to mental, behavioral and neurodevelopmental disorders.
In Maine, the issue has not gotten much attention so far, either, according to Sheila Comerford, executive director of the Maine Psychological Association.“My guess is as Oct. 1 gets closer we will see more action on the listserv on the topic,” she said.
By Catherine Robertson Souter