January 13, 2016
The World Health Organization (WHO) lists the 10th revision of the medical classification directory known as the International Statistical Classification of Diseases and Related Health Problems (ICD) or ICD-10. It is a clinical cataloguing system and offers more codes (68,000) to differentiate illnesses, report and track epidemiological trends, along with enhanced reimbursement assessments than was provided in ICD-9 (13,000).
Physicians' patient encounters, financials and compensation, and career opportunities are affected by ICD-10. Though physicians working in hospitals or as independent practitioners have been wary about the changes from ICD-9 to ICD-10, it is apparently been viewed as a change for the better to embrace ICD-10. While the transition can take long, it is considered beneficial in the long run. Apt training should be given to coders who can be updated with the new coding system and use it for enhancing the revenue cycle. Here are some ICD-10 facts that have helped independent practitioners a great deal-
Independent practitioners can use specific coding for illnesses which were earlier defined as 'unspecified' or 'not elsewhere classified' often leading to denials and were not reimbursed in turn affecting revenues.
The independent physician and the staff should be familiar with the new coding system as it provides a better diagnosis of illnesses that couldn't be diagnosed earlier in ICD-9; thereby giving rise to improved outcomes and diminishing probable compliance issues.
Category and scope of diagnosis:
Physicians can effectively manage patients and be able to diagnose, report and assign codes for those with acute or multiple conditions. Physicians can conclude the severity of the infirmity and prove the medical service necessary.
As ICD-10 allows granular coding, independent practitioners are able to differentiate and report for patients who are new or those who need treatment for a longer period thereby. This will give rise to financial remuneration as an electronic trail can be created giving accurate evidences for precise payments.
Identification and preventive care can be provided to patients who are in need of constant attention e.g. diabetes. Also, injury research, global epidemics and threats, trauma service evaluation can be tracked and responded to with relevant causes and outcomes with the international community.
As data is more detailed in ICD-10, there will be lesser frauds which otherwise amount to losing huge premiums. With ICD-10, physicians will be in a better space for attaining reimbursements in full.
With the accurate cataloguing system of ICD-10, electronic health records and other reporting systems will aid in reducing errors and ensuring accurate billing and appropriate reimbursements from insurance providers/patients.
An enhanced clinical picture of the physicians' documentation is possible with ICD-10 codes. Hence, regular audits can be ruled out as the accurate data is already available.