ICD-10 is the updated International Classification of Diseases, crucial for modernizing medical coding with increased detail and specificity, mandated by HIPAA, and essential for accurate healthcare data and efficient claims processing.
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So,
what is ICD-10? ICD-10 stands for
International Classification of Diseases 10th edition. It's the new and
improved
updated version of ICD-9. Now, ICD is split into two
systems: ICD-10-CM -- Clinical Modification
for diagnostic coding, used by all health care providers, and
ICD-10 PCS -- Procedure Coding System
for inpatient procedure reporting, used by hospitals. Why do we have to move to
ICD-10?
Two reasons: 1) ICD-9 is over 40 years old,
and, 2) ICD-9 has run out of room.
There are just no more numbers to use. With new discoveries and diseases,
the new ICD-10 code set is needed to keep up with the fast-paced changes in
medicine today,
and to add more detail to diagnosis codes. Actually,
the US is one of the last countries in the world to adopt ICD-10.
We better get moving, because they're already working on ICD-11.
As you know, ICD-9 codes have only five, mostly numeric, digits,
with a few E and V codes thrown in for good measure. ICD-10 codes are alphanumeric
with letters and numbers mixed in. Codes can have 3,
4, 5, 6, or 7 digits. For comparison,
ICD-9 has 14,000 codes; ICD-10,
69,000. So, you may ask, "How am I supposed to learn
69,000 codes?" Don't get too scared. A chunk of those new codes have to do with
laterality,
or location on the body. You will, though, have to know more about anatomy in ICD-10
when you look up a code in the book, because the index is laid out by
organs and structures. The higher level of detail that ICD-10 offers
will help standardize data for analysis and streamline the claim submission
process.
The extra detail will make the claims easier for payers to understand
and pay. . . or so they say. And guess what law requires us to move to ICD-10?
HIPAA. And you just thought HIPAA met you couldn't tell your neighbor about your
patient's nasty rash.
When will ICD-10 implemented? It's already been changed a few times.
Will it be postponed once more? Only time will tell. Keep in mind
that whenever ICD-10 takes effect, by not coding and documenting properly,
your revenue and cash flow will suffer, and you'll have to spend a lot more time
correcting, appealing, and resubmitting claims.
Oh, and did I mention that the AMA said it would cost practices
thousands of dollars to implement ICD-10?
Nuts, huh?
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