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Introduction of latest electronic diagnostic codes in the U.S. delayed

April 21, 2014

By Kelly Soderlund, ADA News staff


Dr. Jurkovich
Dentists will have more time to implement the latest version of the International Classification of Diseases, thanks to an extension the U.S. Senate passed March 31.

The Protecting Access to Medicare Act of 2014 moves the deadline for complying with the 10th version of the ICD from Oct. 1, 2014, to no earlier than Oct. 1, 2015.

The additional time gives the health care industry an opportunity assess the challenges of implementing ICD-10 and to develop consensus in the industry on how to be overcome those challenges, according to a news release from the Workgroup for Electronic Data Interchange, which was formed by the Secretary of Health and Human Services in 1991 to be a leading authority on the use of health information technology to improve health care information exchange.

"WEDI believes that the delay in the ICD-10 CM compliance date will help avoid potential disruptions in the health care system by allowing all affected entities more time to complete the necessary work and conduct extensive testing. IT is not a reason to pause," said Devin Jopp, WEDI president and CEO.

ICD-10 CM will be the latest version of the disease classification used in the United States to record many types of health and vital records, including death certificates. Europe is already using ICD-10 and is working to implement ICD-11.

"The parts of the dental community most affected by diagnostic codes remains the oral surgeons; those treating temporomandibular disorders, facial pain and sleep apnea," said Dr. Mark Jurkovich, who chairs the International Health Terminology Standards Development Organization's Dental Specialty Interest Group and is also a member of the ADA Council on Dental Benefit Programs. "It also affects our smaller specialty groups like oral pathologists and oral radiologists, pediatric dentists and others who may treat patients in a hospital or outpatient surgical center and those who do more specialized services such a periodontal surgeries. Some of these services are paid for by medical plans in certain areas of the country. Still, this is just a small percentage of all claims filed by dentists in any year."

Some of the state Medicaid programs may require ICD-9 CM or ICD-10 CM diagnosis codes for dental claims in the future. But those diagnosis codes may only be necessary to report to all other payers when the diagnosis may have an impact on the adjudication of the claim in cases where specific dental procedures may minimize the risks associated with the connection between the patient's oral and systemic health conditions.

Educational materials regarding ICD codes are being developed to include in the ADA's CDT Companion guide, which will be available this fall.

ICD-10 was endorsed by the World Health Assembly in 1990 and WHO Member States began using it in 1994. The WHO worked with the ADA to use its Systematized Nomenclature of Dentistry, also known as SNODENT, to determine if the oral health codes within ICD-11 were complete, comparable and compatible.

SNODENT is a vocabulary designed for use in the electronic health records environment. Any dentist who uses electronic health records or who plans to in the future should be aware that the use of diagnostic codes is on the horizon.

SNODENT will be an important component within certified Electronic Health Records Systems for the federal and state governments' Medicaid and Medicare EHR Incentive Programs—known as the meaningful use of certified EHR technology. SNODENT has been mapped to both ICD-9 CM and ICD-10 CM. In addition, a subset of SNODENT has been developed with mappings to ICD-9 CM, ICD-10 CM and the CDT. SNODENT is distributed by the ADA as a set of downloadable files, which are available to the oral health community under license.

For more information on SNODENT, visit ADA.org/snodent.