The ICD-10 is not a mere update in the coding system. ICD-10 is a simplified set of codes that allows for greater “specificity” in stating a patient’s exact medical condition and the procedure performed. This specificity will provide multiple benefits to health insurance billing and coding, as well as the healthcare industry.
Improved quality in clinical documentation: The ICD-10 coding system is highly dependent on clinical documentation. Since thousands of diagnostic and procedure codes have been added to ICD 10, the accuracy of the codes depends on clinical documents. So, with the implementation of ICD-10, the quality of clinical documentation will improve.
Improved quality of care: With ICD-9, the main focus was to improve reimbursement. But, the ICD-10 coding configuration supports “performance based payment” system instead of targeting returns. This will change the way healthcare is and improve the quality of care.
Preventing Health Care Fraud Activity: The National Health Care Fraud Association (NHCAA) cites that between $70 billion and $234 billion are lost annually through health care fraud. Health care fraud is also becoming common in the medical billing industry, primarily targeting health insurance billing and coding manipulations involving medical billing service provider companies, hospitals, and other health care entities. medical. ICD-9 is more generic and allows for adjustments to the coding for better reimbursement. But, in the ICD-10, the codes are specific and largely avoid manipulation. This, over a period of time, will also have control over fraudulent medical billing activities.
Reporting Features: Since ICD codes are used for health surveillance and also for research, the specificity in ICD-10 will reveal the exact health condition of people in the US For example, for ‘Brain Tumor’ ‘, the assigned CM ICD-9 was generic. In ICD-10 CM, there are specific codes to mention whether the ‘right’ or ‘left’ hemisphere is affected and whether it is ‘occurrence or recurrence’. All this will provide a better understanding to the health care department and help in efficient “disease management”.
Interoperability:
Sharing health information with other countries is difficult for the US with ICD-9, since all but a few other countries follow the ICD-10 coding system. Now, with the implementation of ICD-10, the US will be able to close the gap by sharing information across borders more efficiently, thereby boosting quality of care.
High accuracy with fewer codes: ICD-10 will contain almost 150,000 codes, including CM and PCS. Although there are thousands of newly included codes, you can accurately describe a medical condition or encounter with fewer codes compared to ICD-9 which needs more codes to indicate the same thing.