Codes in the ICD-10-CM code set are more detailed than the codes included in ICD-9-CM. To assign these detailed codes, physician documentation will need to include more specific and detailed information. There are ICD-10 codes for unspecified conditions, and coders have indicated they could avoid the query process and assign these unspecified codes when the physician documentation does not include the detail necessary to assign a more specific code. CMS wants coders to assign the ICD-10 codes that provide detailed information.
An IRF must meet certain criteria to be excluded from the Inpatient Prospective Payment System (IPPS) and the DRG payment methodology. One of the criteria states that 60 percent of the IRF’s total patient population must require treatment for one or more of 13 specified conditions. These conditions include: