Major Changes from ICD-9-CM to ICD-10-CM

In general, most of the changes were of the following types:

• Grouping of codes—Conditions have been grouped in a more logical fashion than in ICD-9-CM. This may have been accomplished by means of movement from one chapter to another or one section to another. Many codes have been added to, deleted from, combined, or moved in ICD-10-CM. ICD-10-CM boasts of some chapters that are entirely unique, although these codes were found in other chapters in ICD-9-CM.
• More complete descriptions—In ICD-10-CM, the subcategory titles are usually complete so that the coder does not have to read previous codes to understand the meaning of the code.
• Fifth and sixth characters—Fifth and sixth characters are incorporated into the code listing rather than having common fifth digits listed at the beginning of a chapter, section, or category.
• Laterality—ICD-10-CM incorporates laterality of conditions or injuries at the fifth or sixth character level.
• Increased specificity—ICD-10-CM offers greatly expanded detail for the various conditions. Many categories, which in ICD-9-CM were limited to three or four digits, have fifth, sixth, and even seventh characters/extensions in ICD-10-CM. In some cases, single ICD-9-CM codes were split into several ICD-10-CM codes to provide greater specificity.
• Excludes notes—There are three kinds of excludes notes that are used in ICD-10-CM.
• Use of extensions—Extensions are used in ICD-10-CM to provide additional information. These extensions are most often found in the injury codes but are found in other chapters. 57
• Combination codes—There are numerous codes in ICD-10-CM that group etiology and manifestation. In ICD-9-CM, generally two codes are required to code etiology and manifestation.
• Terminology used—Many of the category code or subcategory code titles have been changed to reflect new technology and more recent medical terminology.
• Postprocedural conditions—There are many more codes added to ICD-10-CM to describe postoperative or postprocedural conditions.
• Trimester specificity—ICD-10-CM codes in the pregnancy, delivery, and puerperium chapter includes codes designating the trimester in which the condition occurs.
• New codes—There are many new codes to ICD-10-CM that were not classified in ICD-9-CM. Notably, codes for blood type and alcohol level are included in ICD-10-CM.

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