In case you missed it, CMS has released the long awaited ICD-10-CM to HCC mappings in July.  While just over 3500 codes in ICD-9-CM map to an HCC/RxHCC code, almost 10,000 codes will map in ICD-10-CM.  Accurate and detailed documentation is going to be more crucial than ever.

With the increased need for specificity and literality required for accurate ICD-10-CM reporting, it is vital that you, as the coder, are up to date on your ICD-10-CM coding guidelines, that as a manager or lead, you educate your staff, and most importantly, that you educate your physicians as soon as possible on any documentation deficiencies.

Just one of many examples where the need for increased specificity plays a role in code selection is when coding Occlusion and Stenosis of the Carotid Artery.  In ICD-9-CM, it was not necessary to know left or right carotid artery to accurately code the condition.  There is only one code to choose from regardless of left or right with a second code to indicate bilateral.  In ICD-10-CM, there are codes for left carotid artery stenosis, right carotid artery stenosis, and one code that now indicates bilateral carotid artery stenosis without having to append a second code for laterality.

Be prepared.  Read your ICD-10-CM guidelines carefully for any changes.  (Ex: Acute Myocardial Infarction duration is 4 weeks in ICD-10-CM vs 8 weeks in ICD-9-CM)

It is up to you to make sure the documentation meets the required detail necessary.

ICD-10-CM Codes That Map –