ICD-10 coding system has been developed by the World Health Organization to help providers improve the quality of care. Compliance to the new system will also help them reduce the cost of care, enhance administrative performance and get accurate payment for new procedures.
Financial Benefits of ICD-10
ICD-10 medical coding will enable physicians to bill for more complex treatments when treating high-risk patients. It will require a high degree of specificity for clinical documentation. Documentation accuracy will help medical coders reduce the number of rejected claims.
- According to a study by RAND Corp, a non-profit research group, successful implementation of ICD-10 can help the US healthcare industry save anywhere between $200 million to $2.5 billion due to fewer denied claims
The new codes will allow physicians to report care complexities in an accurate manner. It will become easy to differentiate between chronic patients and patients who require a new treatment regimen. Currently, this differentiation is not very clear under ICD-9, resulting in many procedures getting billed as “unspecified”.
Enhanced Efficiency for Healthcare Organizations
New data generated by ICD-10 will help in tracking and responding to global health threats. Medical practices will get better metrics to measure their performance, spot the latest trends and identify opportunities for greater efficiency.
The ICD-10 data will help providers and payers indentify patients who require disease management. For instance, diabetes has a six-fold expansion in number of codes under ICD-10. This expansion will enable to choose the right patient for the right health program. This will also help the providers improve their disease management for patients who are already a part of such programs.
Reduced Chances of Fraudulent Claims Submission
According to the industry experts, implementation of ICD-10 will help reduce submission of fraudulent claims. Such claims are estimated to cost billions of dollars every year to the healthcare industry. Once the new coding system comes into effect, the algorithms used by payers for detecting fraud will gradually be refined. They will be able to spot patterns of legitimate billing. Detailed data will help in investigation of medically unnecessary claims.
Is your Practice Prepared for Implementing ICD-10 ?
ICD-10 might be challenging but once implemented in the right manner, it will bring various benefits to medical practices. ICD-10 will become the new baseline for clinical data, documentation, public health reporting and claims processing from October 01, 2015. It will become important for the healthcare providers to understand patient encounters and prepare for the transition. This will be necessary for ensuring the financial sustainability of their practice.
Since the new coding system will impact patient care as well as the bottom line of a medical practice, many providers have started outsourcing medical billing and coding services. They are relying on the expertise and experience of reputed billing companies like MedicalBillersandCoders.com to sail through the complexities of ICD-10.
Companies like MBC deliver error-free medical billing and coding services, helping practices obtain timely payments. They have a team of skilled billers and coders who are well-trained in ICD-10 coding, HIPAA compliance, denial management and appeal procedure.