ICD-9-CM Coding Guidance for LTC Facilities. Appendix A: Planning for the ICD-10-CM Transition for LTC Facilities

On January 16, 2009, the Department of Health and Human Services released final rules to adopt X12 Version 5010 claim form of HIPAA's Transaction and Code Set Standard and ICD-10-CM and ICD-10-PCS. Healthcare organization must implement version 5010 by January 1, 2012. The implementation deadline for ICD-10-CM/PCS is set for dates of service on or after October 1, 2013.

Long-term care (LTC) facilities are exempt from implementing ICD-10-PCS, which is designed for inpatient hospital procedures. However, they must implement ICD-10-CM. ICD-10-CM is used to report diagnostic codes for all healthcare settings.

While preparation will encompass many aspects, facilities should evaluate their current uses of ICD-coded data and how they will be affected by ICD-10-CM. Other items facilities should consider include, but are not limited to:

  • The financial resources available to support tasks like training, system changes, etc.
  • Software and hardware requirements. Facilities should work with software vendors to ensure timely preparation for the changes needed to their electronic systems.
  • Compatibility with existing systems.
  • Education and training needs at all levels. Coding professionals and those requiring more in-depth knowledge of the code system will require training.

ICD-10-CM codes are more specific and detailed in general as compared to ICD-9-CM. Code selection depends upon accurate and complete documentation. Coding staffs should look to improve their knowledge of anatomy, physiology, and pathophysiology and expect that there will be a learning curve and a personal investment of time and energy to adequately prepare for the transition.

Organization should assess their training requirements, including the level of detailed knowledge required by various staff. Coding professionals will need to be trained on the ICD-10-CM code structure.

It is suggested that in-depth training for actual use of the ICD-10-CM system be scheduled two to five months before implementation.

Assessing current ICD-9-CM coding rules and regulations knowledge helps facilitate development of an educational plan.

AHIMA's ICD-10 Web site at www.ahima.org/icd10/default.aspx provides further details regarding ICD-10-CM

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Article citation:
AHIMA. "ICD-9-CM Coding Guidance for LTC Facilities. Appendix A: Planning for the ICD-10-CM Transition for LTC Facilities." Journal of AHIMA 81, no.10 (October 2010): expanded online version.