What is ICD-10? Everything you Need to Know

February 2, 2024

Leona Rajaee

This blog was originally published in August 2017 and was updated in February 2024

The International Classification of Diseases (ICD) began as the International List of Causes of Death, adopted by the International Statistical Institute in 1893. The World Health Organization (WHO) was entrusted with the ICD system in 1948, publishing the sixth edition as ICD-6.

What is ICD-10?

ICD-10, as defined by the World Health Organization (WHO), serves as the diagnostic classification standard for all clinical and research purposes. The ICD-10 meaning extends to being a comprehensive clinical cataloging system implemented in the U.S. healthcare industry, facilitating the systematic recording, analysis, interpretation, and comparison of mortality and morbidity statistics. ICD is designed for:

Easy storage, retrieval, and analysis of health information for evidenced-based decision-making.
Sharing and comparing health information between hospitals, regions, settings, and countries.
Data comparisons in the same location across different periods.

Challenges with ICD-10 codes

Independent physicians and their staff face several challenges with ICD-10. Here are a few of the biggest challenges:

Maintaining thorough documentation

Now in its tenth revision and known as ICD-10, the coding system is seen by many independent physicians as a source of stress and frustration. Though helpful for categorizing and tracking patient data, ICD-10 is a major shift from its predecessor, and as of October 2015, is mandated by the Centers for Medicare & Medicaid Services (CMS) as a replacement for ICD-9.

ICD-10 is more complicated and more specific. While the old ICD-9 codes used 3-5 characters consisting only of numbers, the new ICD-10 system uses codes with 3-7 characters in an alphanumeric combination, thus allowing for greater specificity in making diagnoses. ICD-9 did not have the specificity needed in many cases to enable the physician to identify, for example, whether a broken bone is in the right or left hand. In addition, most other countries had already transitioned to the ICD-10 system so the US mandate was effective in making coding systems compatible for collaboration internationally.

Staying on top of changes to ICD-10

ICD-10 undergoes regular updates and revisions, requiring constant education and adaptation for independent physicians and their staff. Staying updated with the changes can be time-consuming for independent practitioners, as these changes can happen fast.

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Investing in ICD-10 training for staff

Independent physicians might lack resources or support to provide their staff with comprehensive training on ICD-10 coding. Without adequate training, there's a higher risk of errors or missed opportunities for accurate coding. Incorrect coding can impact reimbursements and billing. Ensuring accurate coding is essential for the financial health of an independent practice.

Memorizing numerous ICD-10 codes

While helpful in identifying conditions and injuries, ICD-10 has been a challenge for many independent physicians. ICD-10 has approximately 69,000 codes compared to the 14,000 ICD-9 codes. The ICD-10 mandate, according to CMS, is required for all medical providers subject to HIPAA regulations, not just for those who bill Medicare or Medicaid.

Providers who use electronic health records (EHRs), however, have found that the transition from ICD-9 to ICD-10 seamless.

How to leverage EHR as a solution for maximum efficiency

Integrating ICD-10 codes into EHR systems is the best way to minimize coding errors. EHRs often have built-in templates and prompts that guide independent physicians to select appropriate ICD-10 codes based on the patient's diagnosis and procedures. This streamlines the coding process and ensures more accurate documentation. EHRs also offer searchable databases of ICD-10 codes, allowing independent physicians to quickly search for relevant codes. Some systems even suggest potential codes based on entered diagnoses, reducing the potential for medical billing errors and saving time.

Having separate EHR and billing systems increases the likelihood of making ICD-10 coding errors since users have to look in two separate systems to select the right code for the patient’s procedure. An integrated EHR and billing software helps independent physicians accurately document patient encounters, assign appropriate ICD-10 codes, streamline medical billing processes, and maintain compliance with coding standards.