Because of this dramatic increase, coders will need to learn new medical terms and new ways of using familiar terms. They will also need to learn an astonishing amount of anatomy in order to assign these new codes correctly. In the not-so-distant future, coders will be expected to know the locations of most arteries, veins, bones, muscles, sinuses, nerves, tendons, ligaments, and lymphatic vessels. Knowledge of the anatomy of the heart will include locations and synonyms for the names of the great vessels, the chambers, septa, papillary muscles, chordae tendinae, valves and valvular structures.
As someone who has been engaged in extensive training, workshops, and seminars in ICD-10, I thoroughly understand the concern that many educators have with the depth of the anatomy necessary for ICD-10. Personally, with my own anatomy and physiology courses recalled only as a distant memory, I wondered how I would refresh my own knowledge. I realized that simply reviewing an anatomy and physiology text was not enough: I needed to know what this new classification system required and what terms it used to describe the anatomy.
Using both volumes of ICD-10, I spent many weeks sorting and categorizing the indices and tabular sections to find out just what terminology was needed (and how it was presented). I discovered that “standard” anatomy and physiology often did not translate directly to ICD-10 terminology and that flexibility in the use of terms was necessary, as not every clinician will be using the terminology that a particular anatomy and physiology text employs.
Additionally, the change from ICD-9 to ICD-10 involves more than a simple increase in the volume of codes due to attention to anatomical detail. The differences also include:
- Laterality of a condition or injury
- Increase in the number of digits and characters, including the use of extensions to provide additional information (for example, the timing of an injury)
- Inclusion of combination codes that include both etiology and manifestation
- The inclusion of information regarding trimester in pregnancy, delivery, and the puerperium
- Postprocedural codes
- Updated terminology and new procedures
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