CPTs Unchanged

Just 22 days till ICD-10 is implemented! It's about to get real. We've spent a lot of time discussing the significant differences between ICD-9 and 10, the need to prepare for the switch, and the difficulties of translating from one to the other. Today we can relax, though -- there are some areas where the switch really will be simple.

As CMS explains in their Myths and Facts info sheet, even though ICD-10 covers more than ICD-9 did, it will not replace other systems of coding, notably CPT codes for procedures. Consequently, where you used ICD-9 with a CPT code with a modifier, you will now use ICD-10 with the same CPT code with the same modifier.

For example, if you see a new patient with a bruise on her right ankle, you would code it correctly as follows:

• ICD10 code S90.01XA (contusion of the right ankle, initial encounter)
• CPT code 99203 (Office Visit, New Patient Level 3)
• Modifier RT (right).

Even though the old ICD-9 code would not have specified the right ankle and the new ICD-10 code does, you still need to use the CPT modifier RT, specifying the right ankle, just like with ICD-9. You'll need to choose the ICD-10 code that specifies the correct laterality, but after that the CPT coding will be just as normal - no modifications to fit ICD-10: no change at all.

Of course, the wrong ICD-10 code can still be a big problem -- if you used S90.2XA (contusion of the left ankle, initial encounter) with the same CPT code and the modifier RT, your claim would be rejected, because the ICD-10 and the CPT modifier contradict each other.

Whether or not you are scurrying to catch up your ICD-10 knowledge in time for the changeover on October 1st, you can rest assured that your CPT coding skills will carry over.

Contributors: Christine Parker, Laura Rowe.