Specialists Face Troublesome Transition to ICD-10

Upgrading from the International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) to ICD-10-CMS codes is a big, expensive job.  After all, the move to ICD-10-CM increases the number of available codes from 14,567 to approximately 68,000, carrying with it implementation costs ranging from $83,000 to $2.7 million per medical practice, according to the American Medical Association (AMA).

It’s even more of a headache for certain specialties that are saddled with a large number of “convoluted mappings” to the new coding system, according to a new study published in the Journal of the American Medical Informatics Association (JAMIA). The study categorized code mapping into five categories: identity, class-to-subclass, subclass-to-class, convoluted, and no mapping. Convoluted mappings are more difficult and expensive because the transition from ICD-9 to ICD-10, in these instances, involves “complex, entangled, and non-reciprocal mappings,” according to the report.

According to the study, “36% of ICD-9-CM code mappings are convoluted and have no straightforward correspondence in ICD-10-CM . . . the convoluted motifs are so complex that substantial discontinuities in reporting patient diseases are expected.”

The proportions of convoluted diagnoses mappings range from 5% in hematology to 60% in obstetrics. In addition to obstetrics, psychiatry and emergency medicine will face onerous challenges as they transition to the new coding system. What’s more, 42% of infectious disease code mappings fall into the convoluted category – and these will have an impact on many specialties.

The research team recommends focusing personnel training and management resources for clinical specialties on the most frequently used and complex mapping motifs, which are now available via web portals. For more details, read the JAMIA paper here.