Part B Insider - 2015 Issue 11
ICD-10: Check 5 Key Diagnosis Code Changes To Perfect Your ICD-10 Claims
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Article Overview
This article reviews five broad ICD-10 transition topics for diagnosis coding, including combination codes, seventh-character use, the shift from V codes to Z codes, limitations of General Equivalence Mappings, and CMS guidance related to code-family billing. It is aimed at coders, billers, and practices working to improve ICD-10 claim accuracy during the early implementation period.
Why This Topic Matters
It helps readers understand which areas of ICD-10 most often affect claim acceptance and coding accuracy during transition, especially for organizations updating workflows and training around diagnosis coding.
Article Sections
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Check 1: Look for Combination Codes
Introduces the topic of ICD-10 combination codes and why they matter for coding conditions with related manifestations. The section provides examples and frames the transition issue from ICD-9 to ICD-10.
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Check 2: Understand the Seventh Character
Explains the general role of the seventh character in ICD-10 and notes that its meaning varies by code section. It also discusses the importance of completeness when a seventh character is required.
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Check 3: V Codes Change to Z Codes
Covers the move from V codes to Z codes in ICD-10 and the broader shift toward more specific encounter reporting. It also references aftercare-related coding concepts.
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Check 4: Beware GEM Shortcomings
Describes the General Equivalence Mappings (GEMs) and their role in understanding relationships between ICD-9 and ICD-10. The section focuses on transition mapping resources and their limitations.
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Check 5: Don’t Fear Code Denials If You Get the Right Code Family
Summarizes CMS guidance discussed in the article and its relevance to claims processing during the ICD-10 implementation period. The section also mentions collaboration between major organizations and transition resources.
What You Will Learn
- How the article frames major ICD-10 diagnosis coding transition issues
- Why combination codes are an important ICD-10 concept
- How the seventh character affects some ICD-10 codes
- Why the move from V codes to Z codes matters
- What GEMs are and why they may not map codes perfectly
- How CMS guidance is presented in relation to claims denials during transition
Who Should Read This
- Medical coders
- Billing staff
- Physician practices
- Revenue cycle professionals
- Compliance and coding educators
Codes Discussed
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