ICD-10-CM or ICD-10-PCS: Which Version Are You Using?

ICD-10 is confusing enough when you’re trying to digest the differences between ICD-9 and ICD-10, but there are also different types of ICD-10 codes that providers should be aware of.

Primary difference between ICD-10-CM and ICD-10-PCS

When most people talk about ICD-10, they are referring to ICD-10CM. This is the code set for diagnosis coding and is used for all healthcare settings in the United States. ICD-10PCS, on the other hand, is used in hospital inpatient settings for inpatient procedure coding.

ICD-10-CM breakdown

• Will replace ICD-9-CM
• Approximately 68,000 codes
• 3–7 alphanumeric characters
• Facilitates timely processing of claims

ICD-9-CM, which is what providers are using today, is similar to the format of the code sets for ICD-10-CM.

ICD-10-PCS breakdown

• Will replace ICD-9-CM for hospital inpatient use only. ICD-10-PCS will not replace CPT codes used by physicians. According to HealthCare Information Management, Inc. (HCIM), “Its only intention is to identify inpatient facility services in a way not directly related to physician work, but directed towards allocation of hospital services.”
• 7 alphanumeric characters

ICD-10-PCS is very different from ICD-9-CM procedure coding due to its ability to be more specific and accurate. “This becomes increasingly important when assessing and tracking the quality of medical processes and outcomes, and compiling statistics that are valuable tools for research,” according to HCIM.

As providers are well aware, ICD-10 is set to begin October 1, 2015. According to several surveys, most practices aren’t confident about their ability to be ready in time. However, the Department of Health and Human Services has indicated no plans to postpone the deadline (which has already been postponed once), so the smartest course of action right now is to roll forward with ICD-10 plans. Interested in an ICD-10 Readiness Checklist? Download our ICD-10 White Paper.

If you have further questions regarding the differences between ICD-10-CM and ICD-10-PCS or about ICD-10 in general, please contact us.