ICD-10 Certification

If your goal is to become a certified medical coder, then you will need to know what codes are used in the industry. The ICD-10 is one of these codes. Learning how to apply the ICD-10 is one of the most important steps to becoming certified as a medical coder.

What is the ICD-10?

The ICD-10 is the 10th edition of the International Classification of Disease. It is a standardized way for diseases and health conditions to be monitored and is made up of a combination of letters and numbers. By using the ICD-10, coders classify diseases, disorders, injuries and various health conditions in an attempt to identify global health trends and statistics.

The World Health Organization (WHO) owns and publishes the ICD. It was created in 1948 and is updated to meet the demands of the evolving healthcare industry.

The most recent update, the ICD-10, went into effect in 2015 and created more condition and diagnosis classifications, which allow more flexibility and precision for the medical coder. In an effort to ease the transition from the ICD-9, two ICD-10 categories were formed: clinical modification (CM) and procedural classification system (PCS).

Comparing ICD-10-CM and ICD-10-PCS

There are two notable similarities between ICD-10-CM and ICD-10-PCS. Neither code is case sensitive, meaning that the letters can be lowercase or uppercase without changing the correctness of the code. Also, both codes contain anywhere from three to seven characters.

The differences between the ICD-10-CM and PCS are much more numerous:

ICD-10-CM

  • Used in clinical and outpatient settings
  • Contains roughly 68,000 available codes
  • The first character is always a letter, excluding ‘U’
  • Decimal point used after first three characters

ICD-10-PCS

  • Only used within inpatient, hospital settings
  • Contains roughly 87,000 available codes
  • The code is made up of numbers that range from zero to nine and any letters excluding the letters ‘O’ and ‘I’ to avoid confusion with the numbers ‘0’ and ‘1’
  • NO decimal point is ever used in the code

When people talk about the ICD-10 without adding the ‘CM’ or ‘PCS’ classification, they are most commonly referring to the ICD-10-CM.

How is it Used?

When a doctor diagnoses a patient they make a written record that describes the specifics of that diagnosis. That record is sent to a medical coder. It is the medical coder’s job to translate the doctor’s written record into medical code using the ICD-10

When you use the ICD-10 you will correspond letters or numbers to the diagnosis, categorization of the diagnosis and, if possible, any extra information related to the diagnosis.

For example, ‘injury’ is a possible diagnosis. In the ICD-10 this would be the first part of the code and would be recorded as a letter. The categorization of the diagnosis in the case of an ‘injury’ could be ‘injury of muscle in the lower leg’ and would be translated into two numbers. If you only receive enough information to make a three character code, that is enough to be considered complete. However, if more information is available be sure to translate that into code for a more complete patient record.

If you seek to become a medical biller and coder you will become part of the system that creates accurate patient records. These records not only add to the healthcare system’s ability to monitor health trends but they also make it possible for a healthcare facility to receive proper reimbursement for services provided to patients.

Do not get discouraged if you have a hard time understanding the ICD-10 codes after your first time reading over the material. The implementation of ICD-10 is extremely complex. Because of this, many schools offer courses that specifically teach how to understand and apply this code. Instead of feeling overwhelmed take the initiative to take one of these courses.

Can I Earn an ICD-10 Certification?

There is no certification that is designed to test your ICD-10 knowledge alone. The certifications that are available in medical coding are created to test your knowledge of the field as a whole. Here are some examples of what a certification exam covers:

  • Current Procedural Terminology (CPT)
  • Evaluation and Management
  • International Classification of Diseases (ICD-10-CM/Diagnosis)
  • Healthcare Common Procedure Coding System Level II(HCPCS)
  • Coding Guidelines

When you seek to earn a certification you will go through one of two nationally recognized agencies:  the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA). Both organizations are qualified and respected throughout the healthcare industry.

The certification exam is extremely rigorous. To give yourself a better chance of passing the test, it is highly recommended that you take medical coding courses to prepare.

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