Benefits of Transition to ICD-10 Medical Coding

Benefits of Transition to ICD-10 Medical CodingICD-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.

FAQs

1. What is the ICD-10 coding system?

ICD-10 is a coding system developed by the World Health Organization to improve the quality of care, reduce costs, and enhance administrative performance in healthcare.

2. How does ICD-10 benefit physicians financially?

ICD-10 enables physicians to bill for more complex treatments, leading to accurate payments and fewer rejected claims, especially when treating high-risk patients.

3. How much can the healthcare industry save with ICD-10 implementation?

According to a RAND Corp study, successful ICD-10 implementation could save the US healthcare industry between $200 million and $2.5 billion due to fewer denied claims.

4. How does ICD-10 improve efficiency in healthcare organizations?

ICD-10 generates better data for tracking health trends, measuring performance, and improving patient disease management, particularly for chronic conditions like diabetes.

5. How does ICD-10 help prevent fraudulent claims?

ICD-10’s detailed coding enables payers to detect and investigate fraudulent claims more efficiently, reducing healthcare costs associated with such claims.

6. When did ICD-10 become mandatory for healthcare providers?

ICD-10 became mandatory on October 1, 2015, serving as the baseline for clinical data, documentation, public health reporting, and claims processing.

7. Why should healthcare providers consider outsourcing medical billing and coding for ICD-10?

Outsourcing to experienced companies like Medical Billers and Coders (MBC) ensures accurate billing, helps prevent claim denials, and supports the smooth transition to ICD-10.

8. How does MBC help with ICD-10 implementation?

MBC provides error-free medical billing and coding services, ensuring timely payments and helping healthcare practices manage the complexities of ICD-10 coding and compliance.

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