such as Pay for Performance and sets the stage for sharing data. ICD10-CM is a classification system to report medical services. It is used to establish policies and is an efficient system for reporting healthcare services, along with quality measurement. It improves claims processing and tracks utilization. ICD-10 CM enables timely reimbursement and also sets the stage for data sharing. There is a common objective between SNOMED and ICD10-CM, offering compatible, collaborative interactions between systems. Essentially, it offers language to code translation for reimbursement systems and is available free from the National Library of Medicine.1 As we plan to transition to ICD-10 on October 1, 2015, use of IMO in the electronic medical record will offer assistance to clinicians in selecting the correct ICD-10 diagnosis code for submission on medical clams. It should be noted that the ICD-10 IMO terminology that includes granularity and specification across medical conditions continues to be developed and enhanced. It is via use and collaboration between the medical community, coders and IMO Inc. that the ICD-10 translation tool will become more robust. Areas of concern include ensuring that the various quadrants for abdominal pain are identified, as a separate code exists for each. Additionally, fracture coding is complicated based on the 16 episodes of care types, as well as the differentiation between traumatic and pathological fractures. The former fracture is due to an injury, and the latter is due to disorders of bone density, such as osteoporosis. The overall coding of these two types of fractures is very different. As new technology is implemented, we must recognize this as an opportunity to collaboratively improve reporting capabilities. Some potential improvements include the assessment of patients for infectious disease risk based on the review of emergency department electronic medical documentation.2 The following are some examples of ICD-10-CM coding that include fractures: MOTOR VEHICLE ACCIDENT Clinical notes: Sixty-two-year-old male presented after a motor vehicle accident on the highway. He was the driver of a car that collided with a bus. Patient suffered a posterior wall fracture of his acetabulum, as well as a left femoral head fracture. Patient also had a type 3 odontoid fracture. ICD-10-CM CODES: Left femoral head fracture: S72.052A Type 3 odontoid fracture, which is a fracture of the neck at the second vertebra: S12.100A 30 HBMA BILLING • MARCH.APRIL.2015 Driver of a car in an accident with a bus: V44.0XXA Activity: car driver collides with bus: V44.5 External status: Y99.8 Place of occurrence (highway): Y92.411 What if this visit was for subsequent care? ICD-10-CM CODES: Left femoral head fracture: S72.052D Type 3 odontoid fracture is a fracture of the neck at the second vertebra: S12.100D Salter-Harris Type I physeal fracture of the upper end of radius right arm, initial encounter: S59.111A Subsequent encounter for crushing injury RT knee: S87.01XD ADDITIONAL FRACTURE AND INJURY-RELATED CODING SCENARIOS Note how the seventh character changes based on the type of fracture. Also note that a pathological fracture related to a bone disease or disorder starts with the letter “M,” and a traumatic fracture due to an injury starts with the letter “S.” For example: Age-related osteoporosis with current pathological fracture right shoulder initial encounter for fracture: M80.011A Osteonecrosis due to previous trauma RT humerus: M87.221 Stable burst fracture of first cervical vertebra initial encounter for closed fracture: S12.01XA Age-related osteoporosis with current pathological fracture vertebra with delayed healing: M19.041 Displaced fracture of right radial styloid process, subsequent encounter with nonunion: S52.511K Stress fracture, left clavicle, initial encounter: M84.312A Displaced comminuted fracture of shaft of ulna left arm, subsequent encounter for open fracture type IIIB with malunion: S52.252R ABDOMINAL PAIN For abdominal pain, it is important to reference the quadrant. Use of unspecified codes in ICD-10 may create reimbursement problems. It is essential to query the physician when there is insufficient documentation to attain a comprehensive ICD-10 code. Here are some examples of abdominal pain: Upper abdominal pain unspecified: R10.10
Billing_MarApr15
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