ICD-10 Changes: What You Need to Know for Accurate Medical Coding

INTRODUCTION:

The ICD-10 system, which was created by the World Health Organization (WHO), has been in development for years. It’s designed to be an international coding standard that allows healthcare providers around the world to use consistent terminology when describing a patient’s diagnosis or procedure. The updated system will bring many changes, but they don’t need to be scary! You can take advantage of many of these new codes to help boost revenue in your practice or hospital setting.

WHAT IS ICD 10?

THE DYNAMICS OF ICD-10 UPDATES:

ICD-10 has been updated several times over the years to align with current medical knowledge; however, these updates have not always been adopted uniformly across all countries. For example: some countries have adopted certain versions while others have not yet done so; some countries have adopted one version while others still use another version or are still in transition from one version to another (e.g., between ICD-9CM & ICD-10).

ICD-10 is used in medical coding to classify the reason for the patient’s visit to the doctor, hospital, or other health service provider. It is also used by public health departments and researchers around the world to track disease trends and epidemics. The U.S. Department of Health and Human Services (HHS) announced that it would be moving to ICD-10 in October 2015, following a push from the American Medical Association (AMA). The AMA had been lobbying the government since 2011 to make this change, citing a need for more accurate medical coding and billing due to growing healthcare costs. ICD-10 will provide more accurate medical coding and billing, which is important because it helps healthcare providers get paid for the services they provide. It will also help researchers gather better data on disease trends and epidemics

WHEN WILL THE TRANSITION TO ICD TAKE PLACE?

• In 2015, the transition is due to take place but will be repeated over several years. The schedule for this process has been made available by the Centres for Medicare &Medicaid Services:
•  October 1, 2014: Hospitals and other providers must begin using ICD-10 codes on all Medicare claims submitted after this date. Only facilities that submit claims electronically shall be covered by this time limit; the submission of paper applications is not affected.
•  January 1, 2015: Hospitals must use ICD-10 codes on all Medicaid claims submitted after January 1st of this year (whether they’re electronic or not).

For providers who have not yet made the switch, it’s important to be aware of these deadlines and begin preparations as soon as possible. Hospitals that do not comply with these rules could face financial penalties or other sanctions from Medicare and Medicaid. The ICD-10 conversion is a huge undertaking, especially for hospitals that have large volumes of claims to process. It’s important to begin preparations as soon as possible and to work closely with your software provider if you’re not sure about your readiness for the switch. One of the big reasons many hospitals struggle to get ready for ICD-10 is that they don’t have the right software. Many hospital systems still rely on legacy systems that do not support ICD-10, which makes it extremely difficult or impossible to make the conversion.

RECENT CHANGES AND REVISION: