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Nutrition Informatics Blog



A Look at Alphabet Soup - ICD-10 Adoption & Nutrition

As part of the Academy’s collaboration with the Healthcare Information Management and Systems Society (HIMSS), we have the opportunity to provide content on-their-web site concerning health IT.  Enter the “ICD Playbook.”  You likely have heard about the upgrade from ICD-9 to ICD-10.  “ICD” stands for International Classification of Diseases.  The ICD is a coding system used to classify diseases, signs, symptoms, abnormal findings, complaints, social circumstances and external causes of health conditions in health records. It is copyrighted by the World Health Organization.  It is used for reimbursement purposes for in-patient health care in the U.S.

So why do dietitians care about ICD-10?

Better documentation –via code sets –allows for better care.  Nutrition care is an integral part of care which has great potential to improve health care and the delivery of health care.

As health IT is adopted, the ability to compare historical digital data will allow for a more efficient reimbursement models.  It is critical to record nutrition diagnoses, intervention and progress in order to clarify the effectiveness of nutrition treatment.

Ancillary pricing models, in particular have room for improvement in reimbursement and outcomes based interventions. Nutrition care needs to be integrated in all coding and vocabularies to best exemplify improved nutrition care.

Why do hospitals and health care providers need to upgrade from the version 9 to version 10?

The 30-year-old code set uses outdated terminology and is not consistent with current medical practice.

Lack of detail in version 9 prevents data analysis for health care utilization and performance measurement. The ICD-9 codes do not provide the level of detail necessary for efficient processing of reimbursement claims.  This adds additional complexity and denials based upon incomplete information.

What is the difference between the two versions?

In short, the ICD-10 version has about 5 times as many terms (68,000 vs. 13,000 with ICD-9)Much greater is provided with ICD-10 (such as descriptions of co-morbidities, manifestations, etiology/causation, complications, detailed anatomical location, degree of functional impairment, biologic and chemical agents, phase/stage, lateralization, age related or joint involvement)—which allows greater potential for inclusion of nutrition related details.

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