ICD-10 Chiropractic Codes Still Missing the Mark


Despite all the buzz about ICD-10 being such a wonderful code set, the oncoming transition to ICD-10 still leaves chiropractors with many questions.  Yes, it is obviously more specific.  Yes, there are new codes that may be much needed (and many that are ludicrous).  But there are still some glaring problems that chiropractors will need to consider in their implementation strategies.  Here are a few examples:

  • There is not a one to one correlation between ICD-9 and ICD-10 codes:  In the vast majority of cases (especially in musculoskeletal diagnosis coding), “plug and play” isn’t an available option.  In other words, it rarely is as simple as entering your old ICD-9 code into a “converter” and the new ICD-10 code spits out.  This occasionally happens, but not nearly enough to make life simple.


  • Subluxation Codes in ICD-10 — From a chiropractic standpoint, the elephant in the room is subluxation coding.  Depending on who you ask and/or which conversion tool you are utilizing, you may end up with at least three distinct options for how to code subluxations in ICD-10.  So, which is the winner?  (See below for a really sad answer) 


  • Payers have not published list of “approved” Dx codes.  Perhaps the worst news of all is that, as of January 2014, no one seems to have a definitive answer. Medicare has not published list of “approved” Dx codes for subluxation. The payers have not expressed a written opinion on which codes they will pay or for what purpose. And absolutely no one at this point has track record of which codes work well and which ones cause problems because ICD-10 isn’t “live” yet.

So How Will Chiropractors Learn ICD-10 Coding?

All of the above is probably a temptation for some to procrastinate learning ICD-10.  Unfortunately, this is likely a huge mistake.  Because ICD-10 not only includes every single code changing (no ICD-9 codes are carried over into ICD-10), the implementation of ICD-10 is going to take some time.  To add to the mess, ICD-10 comes with its own set of unique coding rules which are a bit of a twist from how things are done in ICD-9.  So that is another reason to get started early.  But perhaps the biggest reason of all is that ICD-10 usage is not going to be gradual; it is being referred to as a “hard start.”  In other words, come October 2014, you are either using ICD-10 or you are losing money (and scrambling to learn it in the process).

The chiropractic gamblers among us can perhaps bet on the long shot to win and hope for an ICD-10 delay.  To me, though, the upside is a small consolation prize and the down side is disaster. If you win, you’ve bought themselves a few months respite until you eventually have to learn ICD-10 anyway.  If you lose, it may cost you your chiropractic business as your reimbursements will be brought to a standstill.

Recommended Solutions for Learning ICD-10

The easiest way to prevent damage to your practice is to learn ICD-10 as soon as possible.  If you don’t want to travel or enjoy the freedom and flexibility of online learning, you should check out our ICD-10 Implementation Training for Chiropractors and Staff.  If you prefer to learn “live” and in person, consider a chiropractic billing and coding seminar featuring ICD-10.  If you just want to fiddle around for now and see how ugly ICD-10 can be, play with the Chiropractic ICD-10 converter by plugging in one of your favorite codes and seeing what it looks like in ICD-10.  It’s not enough to learn how to use ICD-10 but it may just spur you on to get moving to do just that!

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