1. ICD-10-PCS Pat Brooks HCFA

2. Development of new procedure coding system • Replacement for ICD-9-CM, Volume 3 • 20 years old • Pilot project 1992 • Three year contract with 3M/HIS - 1995

3. Summary of Project • Year 1: Complete first draft of system • Year 2: External review and limited testing • Development of training guide • AHA & AHIMA informal coding test • Physician specialty review • Year 3: Formal testing & production of final draft

4. Testing • Clinical Data Abstraction Centers (CDACs) testing system • FMAS, Columbia, MD • DYNEKePRO, York, PA • Coded 5,000 records • Identified revisions needed • Gave feedback on issues found to 3M • Comparison test of 100 records • Currently performing additional testing on ambulatory records

5. Modifications as a result of testing • Not Otherwise Specified (NOS) codes added • Number of approaches reduced from 17 to 13 • Dual numbering - with and without imbedded meaning • Training manual revised • Added index entries

6. Major findings as result of testing (1) • More complete than ICD-9-CM, greater specificity and detail • Easy to expand the system • Hierarchical structure makes it easier to learn and understand • Standardized terminology makes it easier to use once the coder has initial training

7. Major findings as result of testing (2) • Should lead to improved accuracy and efficiency of coding • Training time will be a factor since it is quite different from ICD-9-CM • Having all terms defined makes it easier to teach • Once a basic knowledge is acquired, the coder does not use the index

8. Status • Electronic version available on HCFA’s home page • www.hcfa.gov , Stats and Data, Public Use Files, • June 1998 draft of ICD-10-PCS including index and tabular • Mapping from ICD-10-PCS to ICD-9-CM • Training manual

9. Next Steps • Findings at May 13, 1999 ICD-9-CM Coordination and Maintenance Committee meeting • Industry input on next steps • Proposals will take place within HIPAA activities