ICD-10: Preparing for the
Challenges Ahead
Robert Janowitz, MD
Medical Director, Illinois Local Markets
BCBSIL
May 26, 2015
12:00-1:00 PM - Centegra Hospital - Woodstock
A Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
an Independent Licensee of the Blue Cross and Blue Shield Association.
Agenda
Why does ICD-10 Matter?
What is Changing?
How do I get ready for ICD-10?
How are we helping you prepare for
ICD-10?
ICD-9
ICD-10
2
ICD-10: Why does it matter?
It’s a Federal Mandate!
•
•
•
•
•
DHHS final rule under HIPAA – new ICD standard
Becomes effective 10/1/2015 – required for all HIPAA-covered
transactions nationally
Effective date or Implementation date means date of service or date
of discharge
No opting out – There are no provisions allowing opt out (e.g. paper
claims, small practices, etc.)
Same implementation date for everyone:
Use ICD-9*
Use ICD-10*
O/P and Professional - Date of service 9/30/15 or earlier
O/P and Professional - Date of service 10/1/15 or later
For E/R and O/P Observation – treatment starts 23:59 or
earlier on 9/30/15
For E/R and O/P Observation – treatment starts 00:00 or
later on 10/1/15
O/P and Professional with from-through dates that cross 10/1/15 – split the record, request, or claim
For I/P Institutional – Date of Discharge 9/30/15 or earlier
For I/P Institutional – Date of Discharge 10/1/15 or later
Prior
authorizations, referrals, orders, and prescriptions written before 10/1/15 for services to be
provided on 10/1/15 and later should contain ICD-10 where ICD is required
3
ICD-10: Why does it matter?
Industry Benefits of the transition to ICD-10
Makes richer data sets available
Helps research and public health surveillance – information on subsets of patients
can be more easily aggregated for large-scale population health analysis
New payment methodologies more practical
The ability to capture greater detail and differentiation in acuity/severity
will make complex outcome-based and risk-adjusted payment
models more mainstream
Drives health systems innovation
Innovations will better reflect the intensity of patient needs
than is currently possible
ICD-10 will provide better information to
accelerate the meaningful use of health data
4
ICD-10: Why does it matter?
Benefits to You
More specific coding – Detail often lost with ICD-9, physicians
had a hard time conveying to payers how sick their patients really are
Finding a diagnosis gets easier – Physicians and coders will find it
easier to look up unusual diagnoses, signs, and symptoms. New AHIMA study
shows conversion costs range from $1,960 to $5,900 for small practices
Avoid audits and future payment delays – Claims are often
suspended for review or denied due to non-specific information, which the
detail in ICD-10 can help eliminate
Makes ICD-9 limitations a thing of the past – ICD-9 increasingly
fragmented and contained archaic medical terminology, contributed to coding
errors and delayed/inaccurate payments
More meaningful management of physician patient populations –
Are you currently tracking a population of diabetic or asthmatic patients in your
practice?
ICD-10 will provide better information about patients’
overall health, aiding in clinical decision support
5
Let’s Hear From A Physician Champion at CMS
As a practicing physician, Dr. Martinez offers his insights about the benefits of
ICD-10 and four key points to help physicians with their transition to ICD-10.
Link to Video – Internet connection required
02:46 min - Right click on link, select “Open Hyperlink”
A new browser window will open, maximize window for best viewing, click “Play” button
6
What is Changing?
ICD-10-CM New and Different Diagnoses
Major Areas of Change
•
•
•
•
•
•
•
•
•
•
•
•
Abnormal Test Findings & Borderline Diagnoses
Acute Myocardial Infarction
Adverse Effects, Dosing, & Poisoning
Atherosclerosis, Angina & Hypertension
Coma
Diabetes Mellitus
Kidney Disease & Urosepsis
OB, Pregnancy, & Newborns
Oncology & Neoplasms
Orthopedics, Musculoskeletal, Injuries & Fractures
Routine Exams / Physicals
Vaccines / Immunizations
8
ICD-10-CM New and Different Diagnoses
New Terminology and Concepts, some examples:
•
•
•
•
•
•
•
STEMI and Non-STEMI instead of “Heart Attack” or “AMI”
Underdosing and more Borderline conditions can be coded
New scales for Asthma (4 levels), Diabetes (5 levels), Coma, and other conditions
Episode of care indicators
Pregnancy coded in trimesters
Only 1 code to use for vaccinations
Routine exams split into “with” and “without findings” categories
Data will behave differently, some examples:
•
•
•
•
•
•
•
Fewer heart attacks (coded for 4 weeks following infarct instead of 8 in ICD-9)
More cancer cases (anemia coded 2nd in ICD-10 after cancer, ICD-9 rule was opposite) when looking
at primary Dx
No V codes for rehab visits, instead this is part of the episode of care digit
Pregnancies include new code for weeks gestation
More combination codes will cause some conditions harder to locate in queries (e.g. kidney failure due
to diabetes)
Abnormal test findings will appear in more records
Smokers and patients exposed to tobacco smoke will appear more often
9
ICD-10 Diagnosis Changes
Asthma
ICD-10 requires the following scales into documentation:
 Mild intermittent
 Mild persistent
 Moderate persistent
 Severe persistent
More instructions to code tobacco
use/exposure
ICD-9-CM
493.22 chronic
obstructive asthma, with
status asthmaticus
ICD-10-CM
J44.1 Chronic obstructive
pulmonary disease with
(acute) exacerbation
J45.42 Moderate
persistent asthma with
status asthmaticus
Z72.0 Tobacco use
Risk Stratification – The varying degrees of asthma severity will make it easier to identify high risk
populations in health care data sets; more identification of patients who smoke/exposed to tobacco smoke
ICD-10 Diagnosis Changes
Acute Myocardial Infarction (Heart Attack:)
•
Duration changed from 8 weeks in ICD-9 to 4 weeks in ICD-10
•
The terms “Acute MI” or “AMI” is no longer used. Codes reflect
newer terminology and distinguishes between ST elevation
(STEMI) and non-ST elevation (NSTEMI) myocardial infarctions
 STEMI of anterior wall, inferior wall, other sites, or
unspecified site
 NSTEMI (subendocardial, nontransmural)
•
Category I21 used for initial treatment of STEMI and NSTEMI
and all continued treatment during next 4 weeks, but use
Category I22 for subsequent episode:
ICD-9-CM
410.71
Subendocardial
infarction, initial
episode of care
ICD-10-CM
I21.4 Non-STelevation (NSTEMI)
myocardial infarction
I48.91 Fibrillation,
atrial or auricular
Initial STEMI or NSTEMI
Subsequent STEMI or NSTEMI during next 4 weeks
Category I21 code used during 4 weeks after first
episode occurred
Category I22 code used when a patient who has suffered an
AMI has a new AMI within the 4 week time frame of the
initial AMI (regardless of site). A code from category I22
must be used in conjunction with a code from category I21.
The sequencing of the I22 and I21 codes depends on the
circumstances of the encounter.
No concept of “initial” or “subsequent” myocardial
Infarction in ICD-9
Risk Stratification – Fewer records with heart attack diagnoses in the same patient population, more
information about the sequence and nature of the event
ICD-10 Diagnosis Changes
Angina, Hypertension, & Atherosclerosis
Angina
• Often occurs in combination codes for atherosclerotic heart disease
• Angina is rarely coded separately, mainly if angina is due to something other than atherosclerosis
Essential (primary) hypertension – only 1 code: I10
• In ICD-10-CM, hypertension not classified by type
(benign, malignant, unspecified)
Hypertension causing chronic kidney disease, heart disease or
both heart and kidney disease each have separate categories of
combination codes, similar to ICD-9
More specificity in heart disease sites, e.g. native vessels,
nonautologous vs autologous grafts
ICD-9-CM
414.00 Coronary atherosclerosis, of
unspecified type of vessel, native or graft
413.9 Other and unspecified angina
pectoris
ICD-10-CM
I25.119 Atherosclerosis heart disease of
native coronary artery with unspecified
angina pectoris
Risk Stratification – Fewer records with angina diagnoses in the same patient population, risk of excluding
hypertensive patients if not looking at combination codes with hypertension, more smokers identified
ICD-10 Diagnosis Changes
Diabetes
Combination codes for diabetes include the type, body system
affected and the complication affected in that body system (disease
+ complication or manifestation), such as:
•
•
•
•
E10.42 Type 1 Diabetes mellitus with diabetic polyneuropathy
E11.21 Type 2 Diabetes mellitus with diabetic nephropathy
In ICD-9-CM, disease and manifestation were coded separately
Multiple diabetes codes can be used when multiple complications involved
5 Categories of Diabetes can be identified (only 1 category in ICD-9-CM)
•
•
•
•
•
E08 Diabetes mellitus due to underlying condition, e.g. Cushing’s or Cystic fibrosis
E09 Drug or chemical induced diabetes mellitus + code for drug/adverse effect
E10 Type 1 diabetes mellitus (not determined by patient age)
E11 Type 2 diabetes mellitus (default if type not specified)
ICD-9-CM
E13 Other specified diabetes mellitus, e.g. post-procedural diabetes;
250.61 Type I
diabetes due to genetic factors
ICD-10-CM diabetes codes do not include concepts of
“uncontrolled” or “not stated as uncontrolled”, Diabetes
“out of control” or “poorly controlled”; instead coded as:
• Diabetes, by type, with hyperglycemia
Diabetes Mellitus
with neurological
manifestations
ICD-10-CM
E10.40 Type I
Diabetes Mellitus
with neuropathy
unspecified
357.2
Polyneuropathy in
diabetes
Risk Stratification – Methods used to detect complications and manifestations in health care data will need to be
modified to include these combination codes, e.g. diabetics with kidney disease no longer coded separately.
Type I and II may be defined differently for the same population
ICD-10 Diagnosis Changes
Routine and Administrative Exams
New information needed in ICD-10 for Exams by physician
which are not well documented in many physician office
records today:
3 categories of routine exams, divided further by nature of
findings
• Z00.00-Z00.01 General adult medical exam
• Z00.121-Z00.129 Routine child health exam
• Z01.411-Z01.419 Routine gynecological exam
• With abnormal findings
• Without abnormal findings
Specific reasons needed for administrative exams
(e.g. “screening physicals”)
• School exam
• Admission to residential institution
• Pre-employment
• Sports participation
• And more…..
ICD-9-CM
ICD-10-CM
V20.2 Routine infant
or child health check
Z00.121 Encounter
for routine child health
examination with
abnormal findings
794.15 Nonspecific
abnormal auditory
function studies
R94.120 Abnormal
auditory function
study
Risk Stratification – Can better identify abnormal vs normal screening exams in a population of patients
ICD-10 Diagnosis Changes
Vaccines & Immunizations
An example of where ICD-10-CM is less specific than ICD-9
• ICD-10: One code, Z23 used as diagnosis for all types of immunizations
• ICD-9: Several codes depending on type of immunization
Procedure code (rather than diagnosis) identifies
• Administration of the injection
• Type of immunization given
ICD-9-CM
V05.4 - Vaccination and
inoculation; varicella
(chicken pox)
ICD-10-CM
Z23 Encounter for
immunization
Code First: any routine
childhood examination
Risk Stratification – Can no longer rely on Dx to identify type of vaccine given, must look to CPT/HCPCS
code for most records
ICD-10 Diagnosis Changes
Orthopedics, Musculoskeletal, Injuries & Fractures
Changing concepts:
• Codes organized by body site, then injury type
• Significant site specificity by bone, joint or muscle
• Many codes added because of number of sites and
laterality included in most codes: right, left or unspecified
• Differentiation between chronic or recurrent conditions
• Conditions that are result of healed injury
Seventh character required to identify the
encounter sequence:
• A = Initial encounter or active treatment
Not always
easy to
• D = Subsequent encounter (Additional
identify in
current
medical
records
qualifiers available for fractures (e.g. delayed
healing, malunion vs non-union)
• S = Sequela
V codes for aftercare eliminated in ICD-10, use
seventh character qualifier instead
ICD-9
ICD-10
V54.16 Aftercare for healing S82.161D Torus fracture of
traumatic fracture of lower
upper end of right tibia,
leg
subsequent encounter for
fracture with routine healing
823.12 - Fracture of tibia and
fibula; upper end, open
S82.421E - Displaced
transverse fracture of shaft
of right fibula, subsequent
encounter for open fracture
type I or II with routine
healing
Risk Stratification – for any particular population of encounters, orthopedic conditions coded under ICD-10
will likely have many more codes per encounter than were possible under ICD-9. Analysis based on principle
diagnosis should be extended to include additional diagnoses to get a full picture of a patient's injury
ICD-10 Diagnosis Changes
Obstetrics, Pregnancy, & Newborns
Mom and Baby records must be coded separately, not
combined
Maternal Records
• Many conditions must be coded to a trimester of pregnancy
• Concepts of "delivered" and "not delivered" are no longer
part of ICD-10-CM (but this information is captured in ICD10-PCS for OB procedures)
• OB conditions (Pregnancy, childbirth and the puerperium
O00-O9A) are never for use on the newborn record.
• Conditions present in a fetus can be coded to a specific
ICD-9
fetus in multiple pregnancies
650 Normal delivery
• If a condition occurs during a specific week during
V27.0 Outcome of
pregnancy, the week can be coded in ICD-10
delivery, single liveborn
• Normal deliveries coded similarly to ICD-9
• 5th digits for "episode of care" have been eliminated
ICD-10
O80 Encounter for fullterm uncomplicated
delivery
Z37.0 - Single live birth
Risk Stratification – new ability to track conditions by trimester, weeks of pregnancy, and fetus affected in
multiple pregnancies
ICD-10 Diagnosis Changes
Obstetrics, Pregnancy, & Newborns
Infant Records
• Normal births coded separately from mother’s record
• Newborn conditions (Certain Conditions Originating
in the Perinatal Period - P00-P96) are never for use
on the maternal record
• Distinction between fetus and newborn in more
diagnoses:
ICD-9
ICD-10
760.75 Cocaine affecting fetus or
newborn via placenta or breast milk
ICD-9
ICD-10
V30.00 Single liveborn,
born in hospital,
delivered without
mention of cesarean
section
*Z38.0 Single liveborn
infant, delivered
vaginally, born in
birthing center or other
health care facility
*New note - Not to be
used on the mother’s
record
P04.41 - Newborn (suspected to be)
affected by maternal use of cocaine
'Crack baby‘
Can only be used on newborn record
Congenital Defects
• These codes may be used throughout the life of the
patient if the condition is still present
Risk Stratification – congenital defect conditions may appear on more records in a population of patients due
to the new guideline to code conditions throughout the life of the patient
Another Physician Perspective
“The current transfer of information is still way too dependent on electronic means that were
good 30 years ago… we need to start looking at how we’re going to get better information
and data transfer to providers to get back to taking care of our patients better.”
Link to Video – Internet connection required
05:24 min - Right click on link, select “Open Hyperlink”
A new browser window will open, maximize window for best viewing, click “Play” button
19
ICD-10 Procedure Changes (Facility Inpatient only)
Procedures Built with Tables, not Lists
1
16 Sections
2
Over 35
Body
Systems
3
4
5
6
7
31 Root
Operations
Thousands
of Body
Parts
Six
Approaches
Hundreds of
Devices
Intermittent
Qualifiers
(Examples)
(Examples)
Graft (e.g. synthetic,
autologous,
nonautologous)
Diagnostic
Prosthesis
Temporary
Intraluminal
Cemented
Leads
Allogeneic
Implants
Zooplastic
Fixation Devices
Multiple
Mechanical
appliances
Type of Substance
(Examples)
Medical/Surgical Section
Medical/Surgical
Obstetrics
Placement
Administration
Measurement &
Monitoring
Extracorporeal Assist
Extracorporeal Therapy
Osteopathic
Other Procedures
Chiropractic
Imaging
Nuclear Medicine
Radiation Oncology
Phys Rehab & Diag
Audiology
Mental Health
Substance Abuse Tx
Central nervous system
Peripheral nervous system
Heart and Great vessels
Upper arteries
Lower arteries
Upper veins
Lower veins
Lymphatic and Hemic system
Eye
Ear, Nose, Sinus
Respiratory System
Mouth and Throat
Gastrointestinal system
Hepatobiliary System &
Pancreas
Endocrine system
Skin and Breast
Subcutaneous tissue
Muscles
Tendons
Bursae and Ligaments
Head and Facial bones
Upper bones
Lower bones
Upper joints
Lower joints
Urinary system
Female reproductive system
Male reproductive system
Anatomical regions, General
Anatomical regions, Upper
extremities
Anatomical
regions, Lower
extremities
Pregnancy
Anatomical Orifices
Indwelling Device
Excision
Resection
Destruction
Extraction
Drainage
Extirpation
Fragmentation
Division
Release
Transplantation
Reattachment
Transfer
Reposition
Restriction
Occlusion
Dilation
Bypass
Insertion
Replacement
Supplement
Change
Removal
Revision
Inspection
Map
Repair
Control
Fusion
Alteration
Creation
Abdominal Sympathetic
Nerve
Open
Anterior Tibial Artery, Left
Cephalic Vein, Right
Cerebral Meninges
Percutaneous
Esophagus, Lower
External Carotid Artery,
Right
Internal Mammary Artery,
Left
Lumbar Plexus
Phrenic nerve
Percutaneous
endoscopic
Via Natural or artificial
opening
Scapula, Left
Shoulder Bursa
Via Natural or artificial
opening endoscopic
Spleen
Subcutaneous Tissue and
Fascia, Left Lower Arm
Ventricle, Right
Via Natural or artificial
opening with
percutaneous endoscopic
assistance
Electronic appliances
Source of tissue used
for bypass or graft
Z = NONE
Z = NONE
Upper Leg Muscle, Right
Uterine Supporting
Structure
External
Values for each position are not interchangeable among sections, body systems, and root operations
Only valid combinations can be coded using carefully organized tables
ICD-10 Procedure Changes
Cardiology Facility I/P Procedure Coding Example
Operation: PTCA of 2 coronary arteries, RCA w/drug-eluting stent & LAD without stent
Two procedures, coded as follows:
Section
Medical and Surgical
0
Body System
Heart and Great Vessels
2
Root Operation
Dilation
7
Body Part
Coronary Artery, One site
0
027034Z
Approach
Percutaneous
3
Device
Intraluminal Device, Drug-eluting
4
Dilation of Coronary Artery, One
Site with Drug-eluting Intraluminal
Device, Percutaneous Approach
Qualifier
No Qualifier
Z
Section
Medical and Surgical
0
Body System
Heart and Great Vessels
2
Root Operation
Dilation
7
Body Part
Coronary Artery, One site
0
02703ZZ
Approach
Percutaneous
3
Dilation of Coronary Artery, One
Site, Percutaneous Approach
Device
No Device
Z
Qualifier
No Qualifier
Z
How do I get ready for ICD-10?
Readiness Survey Results*
VENDORS
When do you plan to have
your ICD-10 Services /
Software available to
customers?

PROVIDERS
What is your expected
date to begin external
testing?
Unknown
10%
Unknown
15%
By Q2/Q3
2015
25%
HEALTH PLANS
What is your estimated
date to begin external
testing?
Available
Now
60%
By
Q1/Q2
2015
40%
Have
Started
50%
Unknown
40%
Have
Started
30%
By Q2/Q3
2015
30%
From the Workgroup for Electronic Data Interchange (WEDI), largest industry ICD-10 surveyor with support from
CMS, Feb 2015 Survey – 1,174 participants (68% providers, 17% health plans, 15% vendors)
23
How do I get ready for ICD-10?
Know your 15 to 30 most frequently used diagnoses
Acute Respiratory Infections
Acute Serous Otitis Media
ICD-9
ICD-10
ICD-9
ICD-10
462 Acute
pharyngitis
J02.0 - Streptococcal pharyngitis
J02.8 Acute pharyngitis due to other
specified organisms
J02.9 Acute pharyngitis, unspecified
381.01 Acute
serous otitis media
465.9 Acute upper
respiratory infection,
unspecified
J06.9 Acute upper respiratory infection,
unspecified
H65.01 Acute serous otitis media, right ear
H65.02 left ear
H65.03 bilateral
H65.04 recurrent, right ear
H65.05 recurrent, left ear
H65.06 recurrent, bilateral
466.0 Acute
bronchitis
J20.0 Acute bronchitis due to Mycoplasma
pneumoniae
J20.1 due to Hemophilus influenzae
J20.2 due to streptococcus
J20.3 due to coxsackievirus
J20.4 due to parainfluenza virus
J20.5 due to respiratory syncytial virus
J20.6 due to rhinovirus
J20.7 due to echovirus
J20.8 due to other specified organisms
You will use a fraction of ICD-10 codes,
just like you use a fraction of ICD-9 today
Find your common
diagnoses in ICD-9, look
them up in ICD-10
Notice that many, but
not all, have more
specific variations in
ICD-10 than existed in
ICD-9
24
How do I get ready for ICD-10?
Know Your Workflow
Exam
Rooms
Scheduling & Front Desk:
•
•
Forms and Systems, Recognize new
alpha/numeric format
Ask about new requirements for prior
authorizations
Exam Rooms:
•
•
Consider impacts to forms & ABNs
(advance beneficiary notices)
Clinical staff training
EMR or Chart:
•
•
System drop downs & forms
System reports
Medical coding:
•
•
•
Requires more documentation
More codes per record
Training & Productivity impacts
Billing & Practice Management:
•
•
•
Review/adjust contracts
Update policies/procedures
associated with a disease/condition
Review Budgets
Scheduling
Medical
Coding
Front
Desk
Orders/Referrals:
Labs
Imaging
Rx
EMR
or
Chart
Billing &
Practice
Management
Orders/Referrals:
•
Make sure providers who fulfill orders
have the right Dx for future dates of
service (consider standing orders)
25
How do I get ready for ICD-10?
Your Roadmap
Plan & Assess
Create a Project Team
Baseline Budget Formulation
Internal Impact Assessment – talk to your staff
External Impact Assessment – talk to your vendors
Remediate
Internal system changes
Vendor system changes
Business Process Changes
Test & Validate
Internal Testing & Validation
External Testing & Validation
Educate
Review & Assess
Medical Coder Training
Physician Training
Office staff, Report writers, & Analytics staff
Key Metrics Review
Comparison Studies
26
How are we helping you get ready for ICD-10?
Test with Us – Available April through September 2015
28
How are we helping you get ready for ICD-10?
Visit bcbsil.com/provider
29
How are we helping you get ready for ICD-10?
Read the Blue Review
30
How are we helping you get ready for ICD-10?
Industry Resources
CMS
Centers for Medicare
& Medicaid Services
CMS ICD-10
Main Page
CMS regulates ICD-10. Not just for Medicare, CMS oversees ICD-10 for
the entire US, including all covered entities like health plans, clearinghouses, vendors
and providers. Part of HIPAA regulations.
http://www.cms.gov/Medicare/Coding/ICD10/index.html
Available at this site:
• Implementation guides by health care entity type: www.roadto10.org
Start Here
• "ICD 10: Getting from Here to There--Navigating the Road Ahead":
http://www.medscape.org/viewarticle/820612_2 - 21 minutes, 0.5 CMEs
• ICD-10-CM & ICD-10-PCS code set downloads; ICD-10 coding manual downloads
• GEMs downloads (forward and backward maps)
• Link to subscribe to CMS news & updates about ICD-10
• CMS testing initiatives through local MACs
• ICD-10 Final Rule language
• ICD-10 Maintenance Committee minutes
• MS-DRG conversion project & backward reimbursement maps
• Links to other organizations with stake in ICD-10
BCBS
ICD-10
Resource Page
http://www.bcbsil.com/provider/standards/icd_10.html
On our Provider Portal
• Hear free webinars
• Links to these resources and more
Start Here
31
How are we helping you get ready for ICD-10?
Other Key Industry Associations
AHIMA
American Health
Information Management
Association
HIMSS
Healthcare Information
Management Systems
Society
WEDI
Workgroup for Electronic
Data Interchange
AAPC
American Association of
Professional Coders
• Medical Coder certifying organization, emphasis on facility coding
• CMS advisor – Helps guide CMS policy about ICD-10
• Good training provider, multiple training formats available
• AHIMA ICD-10 Home page: http://www.ahima.org/icd10/default.aspx
• Links to online training, implementation guides, regulatory news
• Integrator for many health information technology topics, including standards like ICD-10
• Developed ICD-10 cost calculator for providers
• ICD-10 Playbook: http://www.himss.org/library/icd-10/playbook?navItemNumber=13480
• National Pilot Testing Program: http://www.himss.org/library/icd-10/national-pilotprogram?navItemNumber=13477 Note: program is co-sponsored by WEDI
• Integrator for many electronic data interchange (EDI) topics,
including standards like ICD-10
• Developed original recommended ICD-10 timeline with NCHICA
• Largest regular ICD-10 surveyor of health care entities
• WEDI ICD-10 Home page: http://www.wedi.org/topics/icd-10
• Medical Coder certifying organization, emphasis on professional coding
• More commercially oriented, good training provider
• AAPC ICD-10 Home page: http://www.aapc.com/icd-10/index.aspx
32