Dual Coding for Home Care Billing Personnel for ICD-10 Should Begin

Has your home care or hospice business stopped its efforts of ICD-10 implementation?  Even though the deadline date for implementation has been pushed out, the Thornberry team recommends that you still move forward with implementation. Thornberry is still moving ahead as NDoc Software already includes both ICD-9 and ICD-10 code sets. Home care and hospice billing staff should begin dual coding as soon as possible so that they can become familiar with the changes, which are significant.

Some of the most notable changes:


  • 3–7 digits; 
  • Digit 1 is alpha; Digit 2 is numeric; 
  • Digits 3–7 are alpha or numeric (alpha characters are not case sensitive); and
  • Decimal is used after third character.
  1. Laterality (left, right, bilateral)
  2. Combination codes for certain conditions and common associated symptoms and manifestations
  3. Combination codes for poisonings and their associated external cause
  4. Obstetric codes identify trimester instead of episode of care
  5. Character “x” is used as a 5 when a code that is less than 6 characters in length requires a 7th character
  6. Inclusion of clinical concepts that do not exist in ICD-9-CM (e.g., underdosing, blood type, blood alcohol level)
  7. A number of codes have been significantly expanded (e.g., injuries, diabetes, substance abuse, postoperative complications)
  8. Codes for postoperative complications have been expanded and a distinction 

The additional changes that can be found in ICD-10-CM are: 

  • Injuries are grouped by anatomical site rather than by type of injury; 
  • Category restructuring and code reorganization have occurred in a number of 
  • ICD-10-CM chapters, resulting in the classification of certain diseases and disorders that are different from ICD-9-CM
  • Certain diseases have been reclassified to different chapters or sections in order to reflect current medical knowledge
  • New code definitions (e.g., definition of acute myocardial infarction is now 4 weeks rather than 8 weeks); and
  • The codes corresponding to ICD-9-CM V codes (Factors Influencing Health Status and Contact with Health Services) and E codes (External Causes of Injury and Poisoning) are incorporated into the main classification rather than separated into supplementary classifications as they were in ICD-9-CM.

Learn more about the benefits of using home health software to ensure compliance during the transition to ICD-10.