ICD-10 implementation is to provide advantages like enhancing the capture of healthcare information along with other benefits to healthcare delivery itself. It is also expected to bring about changes in medical billing practices, likely to cause considerable slowdowns and upheaval in billing and payment, if not implemented in the right way; following elaborates some of the ICD-10 challenges to anticipate:
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ICD-10 has 10 times the number of codes compared to ICD 9CM - Coders knowledge of anatomy and physiology, as well as medical terminology will require to be more detailed
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Coders will need to work more closely with doctors to update them on proper coding methods
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More codes to choose from may eliminate use of super bills – a means of quick coding diagnoses
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Providers may need to invest in new software designed to accept the longer digit codes for which billing professionals need more training
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Physicians will need to be more specific in their documentation and code observations as ICD-10 codes include more payment limitations for services
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Billing professionals will need to increase patient education on coverage charges
The Centers for Medicare and Medicaid Services is standing firm on the ICD-10 compliance date of 1st October 2013, stating there will be no delays or grace period and Medical Coder’s need to look into these challenges immediately. Moreover ICD-10 is not going to be just learning of increased number of medical codes, but a streamlined training process that involves:
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ICD-10-CM Implementation Training
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ICD-10-CM Anatomy and Patho-physiology
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ICD-10-CM Code Set Training (Phase 1)
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ICD-10-CM Code Set Training (Phase 2)
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ICD-10-CM Proficiency Assessment
Hence, we as Medical billers and coders need to get industry-ready and make the most of the remaining 87 weeks before the ICD-10 deadline, the program being an incentive to billers and coders to excel in their billing and coding profession.
The challenges elaborated above along with the following table depicting the comparison between the ICD-9 & ICD-10 code sets gives us a sense of the humungous task in front of us.
Comparison of the diagnosis code sets
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ICD-9 |
ICD-10 |
What this means for us? |
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3-5 characters in length |
3-7 characters in length |
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More thorough research
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Double checking once code is applied
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Approximately 13,000 codes |
Approximately 68,000 available codes |
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More references required
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More options required for the same diagnosis
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First digit may be alpha (E or V) or numeric;
digits 2-5 are numeric |
Digit 1 is alpha; digits 2 and 3 are numeric;
digits 4-7 are alpha or numeric |
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Technicality on the rise
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Initial practice will be difficult
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Limited space for adding new codes |
Flexible for adding new codes |
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Change will be a part of our lives from now on
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Lacks detail |
Very specific |
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Depth of knowledge required, must be specific with the anatomy and physiology
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Lacks laterality |
Has laterality (i.e., codes identifying right vs. left) |
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Being specific will be our job
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(Source: American Medical Association)
For more information on ICD-10 facts - “Comparisons of Diagnosis Code”, etc. refer to following link: icd10-icd9-differences-fact-sheet.pdf
Notwithstanding your earnest efforts to upgrade your billing and coding knowledge to the request demands of ICD-10 and HIPAA 5010 medical billing environment, we are concerned that you may be missing out on necessary links and networks that makes upgrading meaningful, complete and fruitful. As certain links and networks along with the requisite learning materials are going to be crucial to an overall ICD-10 competence, Medicalbillersandcoders.com - strives to complement your efforts with reliable information on:
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Credible sources for learning materials on ICD-10 and HIPAA 5010
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Recommendations on EHR platforms for ICD-10 and HIPAA 5010 compliant medical billing and coding
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Certifying agencies (such as AAPC) for diverse certification programs in medical billing and coding
In conclusion we would like to add the training program will soon be offering to subscribers a platform to share their views by participating in polls and associating with industry experts. We invite medical coders to send in their comments, recommendations - contribute to ICD-10 in their own way. MBC has been serving physicians for more than a decade also offering medical billers and coders an avenue to get connected with these doctors and can register with us for future job prospects.
With this prelude to the scope to this ICD-10 Training Program, we once again extend our invitation to the medical billing and coding fraternity – come, join, and spread the word about making this humungous task a real, fruitful and meaningful one.
With your regular participation we want to make ICD10 as simple and interesting: Participate in the ICD-10 Program
If you have not enrolled for ICD-10 trainings, do it now