ICD-10 code changes will apply from the 1st of June 2013
 and Phase 3 and 4.1 will be implemented on 1st January 2014

What does this mean?

1.       ICD-10 codes are in conflict with the patients age or gender.

2.       If certain combination codes have been omitted, or

3.       If invalid codes have been used wrongly in the primary or secondary position.

These warning messages will turn into rejections on the 1st of January 2014

Phase 3 explained

  • You must always submit valid 3,4 and 5 character level codes

  • You must use valid primary codes in the primary position and valid secondary codes in the secondary position. These codes can be identified on the ICD10 MIT 2013

  • Combination codes must always be used together i.e.: 

           1.    All S & T codes must always get a secondary external cause code V, W, X  or Y

           2.    These eternal cause codes must be 5 character level codes.

Codes that are flagged with an asterix*, must always be used in the secondary position and in combination with another code called the dagger code, which would fall into the primary position.

Phase 4.1 explained
  • Implementation of Gender edits i.e.: Gynae codes can only be submitted for females.
  • Implementation of Age edits i.e.: an ICD-10 code with the full description including the words Puberty, Adults or infants can only be submitted for these specified age groups.
  • Implementation of ICD-10 (morphology codes i.e.: M8084/3). 

1.   The morphology code records the kind of tumour that has developed and how it behaves. 

2.   This means that morphology codes will need to be supplied with all chapter 2 (Neoplasm) codes where surgery has been performed

3.   Or where pathology/ laboratory investigations have been done to confirm the underlying cell type of the neoplasm.

When the doctor performs an excision of a skin lesion he will now have to submit both the ICD-10 codes and morphology code.

If you have any questions about the ICD-10 codes please call us on 031 9049200 or email info@medprax.co.za        

                                                                       http://www.medprax.co.za