With ICD-10 implementation, the hospitals will now have 87,000 new ICD-10-PCS codes for facility in-patient procedure coding. These codes replace the existing 8,660 CPT codes, but only for in-patient procedures and studies. However the ICD-10-PCS “hospital in-patient procedure codes” cannot be used for billing the radiologist’s professional component on these procedures and studies. They also cannot be utilized for coding out-patient imaging procedures or studies. Therefore, procedures performed on inpatients are described by ICD-10-PCS codes, yet the identical procedures must be described using the old original CPT codes if performed on outpatients.
Certain payors will not be converting to the ICD-10 codes. This will be the auto insurance industry, workers comp, and legal claims. This is why for several years your hospital downloads will likely be providing a mixture of ICD-9, ICD-10, ICD-10-PCS and original CPT codes to practice management and billing systems. Even with Hl-7 standardization there will be problems. If your present billing system downloads hospital information, it will likely “crash” with ICD-10 implementation. Your management system must not only have the ability, but also the knowledge to know when to automatically convert ICD-9 codes to 10, ICD-10 codes back to 9, and ICD-10-PCS codes to CPT codes; and it must do so with ease, comfort and efficiency.
It is uncertain as to how the dictation systems and the actual radiology reports will handle these changes. In ICD-10 the diagnosis description is physically quite large yet critically necessary. It will likely exceed the width of the “diagnosis description" field for most systems that normally try to display it on the radiology report. Radiology reports will vary greatly; some having a CPT or ICD-10-PCS procedure code and possibly an ICD-9 or ICD-10 diagnosis code or just a simple diagnosis description or “reason for exam”. Even those radiology reports containing better than average descriptions for “reason for exam” and “diagnosis description”, will still be very difficult and possibly impossible to code under the ICD-10 standards. Reimbursements will reflect these difficulties.