Dental Sleep Medicine Insider September 2015 | Page 17
ICD-10
WHAT DOES THIS
MEAN TO YOU?
By Dr. Stacey Layman
[email protected]
There is a good chance you have heard of the upcoming ICD-10
changes but you likely aren’t quite sure what it all means.
Your physician peers know all too well what this means. On October 1, 2015 the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD) goes into effect. This is a code set developed by the World Health Organization that
helps describe diseases, abnormal findings, external causes of injury, signs and symptoms, complaints and social circumstances. ICD –
9 had more than 13,000 codes but this new set of codes in ICD – 10 has over 68, 000! More than 5 times the number in ICD-9! Why you
ask?
The new codes will allow more information to be conveyed in a code reducing the need for narratives and modifiers. It will be a huge
undertaking for any physician or hospital as they use many codes every day. For dentists, I have good news! The new codes are only
diagnosis codes! Most of us use one main code, 327.23 obstructive sleep apnea. Others we might use would be for co-morbidities such
as Hypertension and Diabetes. Fortunately, we have a very limited number of these codes and our procedure codes such as E0486 will
not change. With all that being said, get ready because this will have an effect on every human being in the United States for many
months to come, and the insurance companies are jumping for joy!
My prediction...
There will be so many rejected claims with months of
corrections and appeals. Of course, this is fabulous news
for insurance companies that like to hold on to their
money. Now they have an additional excuse! Pardon me
as I briefly delve into conspiracy theories, but I don’t
believe it’s a coincidence that this is all happening in the
4th quarter when most patients have met their deductibles
and insurance companies pay out billions. For now, rejoice
in the fact that our own specialty won’t be affected much.
Below is a chart with the old and new codes for dentists
billing medical insurance for sleep apnea. Change is
constant so thank goodness for GoGo Billing. We’ll take
away much of the pain of this change for you. Stay tuned
for more articles on the ever-changing DSM insurance
landscape.
Condition
Obsructive Sleep Apnea
Hypertension
History of Stroke
Insomnia with Apnea
Cardiac Arrhythmias
Insomnia
Impaired Cognition
Obesity
Exxcessive Daytime Sleepiness
Mood Disorders
Diabetes Mellitus
ICD-9
327.23
401.9
V12.54
780.51
427.9
780.52
331.83
278.0
780.79
296.9
250
ICD-10
G47.33
|10
Z86.73
G47.30
|49.9
G47.00
G31.84
E66.9
R53.83
F39
E11.9