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RE: Lack of ICD-10 Crossovers

From: Jeffrey Kass, DPM


Since the implementation of ICD-10, it has become obvious to us all that there are many ICD-9 codes that have no ICD-10 crossovers. Furthermore, many of the ICD-10 codes are "unspecified", which is counterproductive to the aim of being more specific, which was supposed to be part of the rationale behind ICD-10. I assume that there is some committee somewhere that is collecting these codes to forward to the people who facilitate new codes. Who are both sets of people? Who are the podiatrists tasked with this? 


I was hoping to find some sort of chart or table on the APMA website to ensure codes I come across are listed, but did not find one. We are collectively making one, correct? 


Jeffrey Kass, DPM, Forest Hills, NY

Other messages in this thread:



From: Paul Kinberg, DPM


Thanks to the efforts of APMA, the association’s members were among the best prepared physicians for the transition to ICD-10. APMA has been working actively to prepare its members for years, and we continue to address the very few concerns that have arisen among our membership. 


APMA does in fact provide a list of codes for which there is not a crosswalk, along with APMA’s action on each of those codes. Members can find this information, along with many other helpful ICD-10 tools, on our ICD-10 Resource Page, APMA’s Coding Resource Center (CRC, does provide a crosswalk from ICD-9 codes to ICD-10. In addition, APMA offers more than 20 free webinars (including the most current from December 10,; countless ICD-10 InSight seminars; our ICD-10 FAQs; ICD-10 Test Your Knowledge; and other resources.


If members have questions about ICD-10, they may contact APMA’s Health Policy and Practice Department directly at


Paul Kinberg, DPM, Chair, APMA Coding Committee



From:  Neil Hecht, DPM


Ode to ICD-10


Hip hip hooray, yippee kay yay

The ICD-10 started today.

The old codes were so few

They were the ones that I knew.


Now 69,000 codes to use...

So much better, I’m so confused.

The patients will get well

Because the statistics will tell.


An ankle sprain on flaming skiis

Sucked into a jet, holy jeez!

Subsequent visits for broken toes

Have different letters, don’t you know?


I could keep on rhyming this nonsense poem

I got to the office early from home.

But I need extra time to code the visit

I need seven things to ID which digit!


Help me survive this latest change

The old codes were easy, these are so strange.

I’m feeling helpless, my brain is frayed

But I’ll do it right so I might get paid!


Neil Hecht, DPM, Tarzana, CA



From: Joseph Borreggine, DPM


So, here we are... hours into the ICD-10 transition. The sky has not fallen, but it might still. "The proof will be in the pudding," as they say. Whether we get paid on these new codes will be up to the insurance companies that we bill. We will see what happens over the next few weeks and months. 


The warnings that we may not get paid in a timely fashion may still occur; so be prepared for some "expected" financial shortfalls in your revenue stream during this transition. It is a good idea to identify any available...


Edior's Note: Dr. Borreggine's extended-length letter can be read here.



From: John Moglia, DPM


There is a free one-hour overview webinar at on code conversion as part of their superbill creation. You can also download free icd9-10 conversion software from My manager and I compiled a list of our most commonly used codes and created our own handbook of codes to be entered into our billing software, as Medisoft's list was not comprehensive.


John Moglia, DPM, Berkeley Hts, NJ



From: Peggy S. Tresky, MA


APMA provides a number of ICD-10 resources to its members at to help prepare them for the transition to ICD-10 scheduled for October 1, 2015. One tool that APMA offers is the APMA Coding Resource Center (CRC), a fully integrated online coding and reimbursement resource for foot, ankle, and leg-relevant CPT, ICD-9-CM and ICD-10-CM (Volume 1, 2), HCPCS Level II codes, and Medicare LCDs CCI edits, and fee schedules.  A portion of your subscription helps support the APMA Educational Foundation Student Scholarship Fund.


In the past month, APMA has added to the CRC an interactive ICD-10 sample diagnosis section of a super bill containing 140 typical diagnoses and conditions for a foot and ankle specialist. In addition, we announced the presence of ICD-10 “shortcuts” that have been added to our ICD-10 Quick List of 1,400 commonly used diagnoses, conditions, circumstances, signs, and symptoms. This “ICD-10 Shortcut” feature opens a window for the ICD-10 code you choose, and shows you the “nth” degree (highest level of specificity choices) along with notes, instructions, and guidelines.


Last night, September 29, APMA hosted another in its series of ICD-10 webinars for members. This webinar was an ICD-10 “Town Hall” presented by Harry Goldsmith, DPM, and members of the APMA Coding Committee. Our ICD-10 InSight Webinars (more than 20 in total) are available for APMA members at no charge at In addition, take advantage of the current trove of ICD-10 resources that can be found at, including ICD-10 “Test Your Knowledge” questions, a list of ICD-10 FAQs, and links to other related resources such as those provided by CMS.


Peggy S. Tresky, MA, Director of Communications, American Podiatric Medical Association



From: Jeffrey Lehrman, DPM 


There is no correlation between ICD-10 and board certification for anyone, neither those who are already diplomates nor those aspiring to become diplomates. 


Jeffrey Lehrman, DPM, APMA Coding Committee



RE: ICD-10 Grace Period (Josh White, DPM, CPed)

From: Jack Ressler, DPM


Josh White DPM wrote a very informative response to my query on the ICD-10 grace period. I'm not sure how other doctors interpret this grace period, but I don't really know what purpose it will serve. If doctors are allowed to submit wrongly coded ICD-10 claims that will not be rejected during a one-year grace period, what steps will CMS take to make this a learning curve? What are doctors going to learn? It seems like it will be another year of delays while the decision-makers try to figure this one out. I still feel the smoke will not settle until after the 2016 election year.


Jack Ressler, DPM, Tamarac, FL



From: Josh White, DPM, CPed


It was good news that CMS recently announced that for the first year that ICD-10 is in place, Medicare claims will not be denied solely based on the specificity of the diagnosis codes as long as they are from the appropriate family of ICD-10 codes. 


This means that Medicare will not deny payment for these unintentional errors as practices become accustomed to ICD-10 coding. In addition, Medicare claims will not be audited based on the specificity of the diagnosis codes as long as they are from...


Editor's Note: Dr. White's extended-length letter can be read here



From: APMA Coding Committee


APMA has reached out to CMS for additional clarification about CMS’ recently announced “flexibility” with regards to ICD-10 coding and claims acceptance following the October 1 transition. Specifically, APMA is seeking a better understanding of what CMS means by “valid code from the right family.”  We will post the CMS clarification when it is received.


It should be noted, however, that CMS has emphasized that ICD-9 codes will NOT be accepted for claims with dates of service after September 30, 2015. APMA will provide updates to the podiatric community as more information becomes available. 


APMA Coding Committee



From Harry Goldsmith, DPM


APMA’s Coding Resource Center (CRC) has not one, but two ICD-10 crosswalk features built into its full-feature ICD-10 tab. In addition, the CRC Library tab includes, for paid subscribers, a completed (to the ‘root’ code level) sample ICD-10 charge ticket section. The CRC is accessible wherever the subscriber has an Internet connection. The CRC includes CPT, ICD-9, ICD-10, HCPCS, CCI edits, and Medicare LCDs. Subscriptions to the APMA Coding Resource Center are available to both APMA and non-APMA members.    


Disclosure: I am one of the primary developers and promoters of the APMA CRC; I make no money from sales of CRC subscriptions.  


Harry Goldsmith, DPM, Cerritos, CA



From: Paul Kinberg, DPM


APMA’s Coding Resource Center (CRC) provides a complete list of ICD-10 crosswalks relevant to the lower extremity. It also includes CPT, HCPCS Level II codes, and Medicare LCDs and fee schedules. Users can save favorites and view tutorial videos. The CRC is available wherever you have an Internet connection, allowing you to look up codes, check CCI edits, review your carrier's LCDs, get the latest coding and reimbursement information, and review a library of guidelines and articles.


APMA members receive a steeply discounted rate for subscribing to the CRC, and a portion of every subscription supports podiatric medical students through the APMA Educational Foundation. A seven-day free trial is available.


Paul Kinberg, DPM, Chair, APMA Coding Committee, Dallas, TX



From: Steve J. Kaniadakis, DPM


Any ICD code number description is only useful when it corresponds to a particular CPT code number description (and vice-versa).  Any CPT code number description is only useful when it corresponds to a particular ICD code number description. A claim can be wrong, incorrect, and even falsely submitted if the ICD and CPT codes are not matched properly  - the wrong ICD for the CPT, or the right CPT but the wrong ICD. 


The way the two pair up is important. A CPT which was once used for billing using a given ICD-9 code may not still be used with that same ICD, because some of the ICD code number descriptions are changing. It's important to also know if the CPT still can be used with that ICD-10 code number description as it was used for a corresponding ICD-9 code number description.


Steve J. Kaniadakis, DPM, St. Petersburg, FL



From: Michael L. Brody, DPM


At this point, I believe that it is important to point out that this 'extra work' in documenting the findings and determining the correct ICD-10 code only needs to be done when you are adding a new ICD-10 code to a patient's problem list. 


Yes, it will be very time-consuming when we first have to convert to ICD-10 and 'update' all of our patients' charts. But once we have documented our findings to substantiate the correct ICD-10 code,  we do not have to... 


Editor's note: Dr. Brody's extended-length letter can be read here.



From: Jared K Remmers, DPM


When it comes to ICD-9 to ICD-10 conversion, the train has already left the station. Starting October 1, 2014, Medicare (CMS and its subsidiaries) will no longer be accepting billing that is not ICD-10 based. All of the large payers are having regular meetings and seminars for billing and coding compliance based on the new ICD-10 system requirements. I recommend that all practitioners start educating themselves on the requirements for ICD-10 documentation. Check with your local hospitals for ICD-10 classes, look to industry sponsored classes, and get educated at the CMS website for ICD-10


If you believe in the saying "follow the money", you will begin to understand that ICD-10 transition is not going to be delayed again, and all of the major insurance carriers are making the transition now and will be ready for October 1, 2014. We should be ready also.


Jared K Remmers, DPM, Portland, OR, JRemmers@LHS.ORG
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