When I started learning ICD coding, my dad, Dr. Robert Day, Sr., was President of the American Optometric Association (AOA), and they had just published the first Current Optometric Information and Terminology (COIT) book in June 1974. It was optometry’s first attempt to participate in the new medical trend of systematically classifying diseases. Optometry was just beginning to become more than simply prescribing a pair of glasses to help patients realize improved vision.
Learning ICD-9 versus ICD-10 is very much like comparing learning multiplication tables to learning calculus. I can’t remember a time when I didn’t know my multiplication tables, but I remember struggling to learn calculus all too well. I probably learned multiplication in the second or third grade. It was a straightforward process where one problem produces only one answer. For example, 2×2 can only equal 4—easy enough, right? Then you advance to calculus (particularly differential) where one problem can produce multiple possible answers. The learning process is far more complex, and the answers, at least initially, are far less obvious. But it can be done; you just need to spend the time to identify your best resource and to understand your goal.
Even now, I calculate simple multiplication in my head, but for calculus I need the help of technology (a calculator) to do calculus. Likewise, ICD-9 is committed to memory, but for ICD-10, I will depend on technology in the form of my electronic health record system to handle most of the ICD-10 coding.
Speculation abounds, but it’s reasonable to assume that ICD-10 will mark the end of the paper super-bill and coding from memory. Under ICD-10, the AOA’s Express Mapping Card alone is four pages with almost 300 codes. ICD-10 is clearly more complex, and trying to manage it without the help of technology will drastically add time and expense to your coding.