If somebody is saying that ICD-10 will change everything, then it’s not wrong. There is a huge difference between ICD-9 and ICD-10. There is difference in terms of; code structure, number of codes, specificity, coding guidelines, classification of codes, code hierarchies, terminologies, and so on the coding process.

One need only training for successful migration is a wrong idea. Real time process involves day to day new issues and resolving them at every step. This is to be addressed before the implementation with lot of practice after training as if we have started working with ICD-10.

Coding of fractures in ICD-10-CM is quite cumbersome. A great deal of patience, with ICD-10 related knowledge of medical terminology, attentive attitude is required with proper training and practice to achieve necessary expertise in ICD-10-CM.

A lot is going to be changed in coding of fractures in ICD-10-CM. The organization of the alphabetic index the number of required digits for a code and the episode for visit are some of the important ones. In fact, the documentation requirements for coding of fractures or its related visits to a healthcare facility are also a whole lot different.

In ICD-9-CM, all the traumatic fractures were classified between categories 800-829 at one place in the chapter injury and poisoning, because the classification of injuries in ICD-9-CM is based on the type of injury. But in ICD-10-CM, the codes for the injuries are arranged by the body part rather than by type of the injury. For example, all injuries to the elbow and forearm are classified between categories S50-S59 that includes contusions, superficial injuries, open wounds, insect bites, fractures, dislocations and sprains, crushing injuries, etc. So the coder would be referring a different code range in the ICD-10-CM each time he searches a code for a different body part fracture.

The most interesting feature in all the fracture codes in ICD-10-CM is that all the codes should have a 7th character extension. The 7th character extensions are required for the fracture codes to add different type of information related to encounter. They must be assigned to all the fracture codes at seventh character position only, even if a fracture code is not of length of 6 characters by using place holder “X” in between.