title: Migration to the ICD-10 coding system: A primer for spine surgeons (Part 1).
abstract: BACKGROUND
  On 1 October 2015, a new federally mandated system goes into effect requiring the replacement of the International Classification of Disease-version 9-Clinical Modification (ICD-9-CM) with ICD-10-CM. These codes are required to be used for reimbursement and to substantiate medical necessity. ICD-10 is composite with as many as 141,000 codes, an increase of 712% when compared to ICD-9.
  
  
  METHODS
  Execution of the ICD-10 system will require significant changes in the clinical administrative and hospital-based practices. Through the transition, diminished productivity and practice revenue can be anticipated, the impacts of which the spine surgeon can minimizeby appropriate education and planning.
  
  
  RESULTS
  The advantages of the new system include increased clarity and more accurate definitions reflecting patient condition, information relevant to ambulatory and managed care encounters, expanded injury codes, laterality, specificity, precise data for safety and compliance reporting, data mining for research, and finally, enabling pay-for-performance programs. The disadvantages include the cost per physician, training administrative staff, revenue loss during the learning curve, confusion, the need to upgrade hardware along with software, and overall expense to the healthcare system.
  
  
  CONCLUSIONS
  With the deadline rapidly approaching, gaps in implementation result in delayed billing, delayed or diminished reimbursements, and absence of quality and outcomes data. It is thereby essential for spine surgeons to understand their role in transitioning to this new environment. Part I of this article discusses the background, coding changes, and costs as well as reviews the salient features of ICD-10 in spine surgery.
authors.affiliation: Department of Neurosurgery, Mayo Clinic, 4500 San Pablo Rd, Cannaday 2E, USA.
authors.forename: Gazanfar
authors.initials: G
authors.lastname: Rahmathulla
authors.affiliation: Department of Neurosurgery, Mayo Clinic, 4500 San Pablo Rd, Cannaday 2E, USA.
authors.forename: H Gordon
authors.initials: HG
authors.lastname: Deen
authors.affiliation: Department of Finance, Division of Revenue integrity, Mayo Clinic, 200 1 St. SW, Rochester, MN 55905, USA.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Dokken
authors.affiliation: Department of Neurosurgery, Mayo Clinic, 4500 San Pablo Rd, Cannaday 2E, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Pirris
authors.affiliation: Department of Neurosurgery, Mayo Clinic, 4500 San Pablo Rd, Cannaday 2E, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Pichelmann
authors.affiliation: Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA ; St. Vincent's Brain and Spine institute, Jacksonville, FL, USA.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Nottmeier
authors.affiliation: Department of Neurosurgery, Mayo Clinic, 4500 San Pablo Rd, Cannaday 2E, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Reimer
authors.affiliation: Department of Neurosurgery, Mayo Clinic, 4500 San Pablo Rd, Cannaday 2E, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Wharen
keywords: Diagnostic coding systems; ICD-10; implementation; practice management; spine surgery