New medical coding: Out with the old: Amputation; in with new: Detachment


Here is a change veterans should be aware of:  The VHA, like all health care stakeholders, is implementing the Tenth Revision of the International Classification of Diseases (ICD-10).  The government-wide conversion deadline is 10/14.

The ICD-10 is far larger and detailed.

ICD-10  Clinical Modification (ICD-10-CM) will go from about 13,000 codes to about 68,000 available codes.  ICD-10 Procedure Coding System (ICD-10-PCS) will go from about 3,000 codes to 87,000 available codes.

This change will impact veterans’ claims in the future.  A 21st Century System for Evaluating Veterans for Disability Benefits (2007), by the Board on Military and Veteran Health, provides an overview of the ICD and VA schedules.  For example, “Raters must match conditions in the medical records to the proper diagnostic code in the Rating Schedule.(p. 263);…VA provides flexibility by allowing the rater to use an analogous condition as a guide for determining the rating percentage.”

The Rater’s schedules only have about 800 codes, many of which are outdated. Veterans lucky enough to have a rating may want to learn about the new diagnostic codes.  Errors are sure to multiply.

Click the image below for a brief discussion of PTSD diagnoses comparing the ICD-10 and the DSM-IV.

PTSD Diagnostic Criteria

Click image to go to VA.

The terminology in the new ICD can be bizarre.  Living babies delivered by all means are now objectified with the term “products of conception” in the ICD-10-PCS.  This bothers me.  Will people with terminal illnesses be referred to as “products of terminal illnesses” in the future? 

New terms, new world?
“Ahhhh, it’s a female product of conception.”

Well, coding is another huge topic.  The resource quoted above is a free download or it can be read or skimmed online.  Scroll down to see the Table of Contents.  Sample chapters:

4 The Rating Schedule

5 The Medical Examination and Disability Rating Process

6 Medical Criteria for Ancillary Benefits

Another good resource:

Private search engine: http://www.icd10data.com/

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