The changeover from ICD-9 to ICD-10 is mandatory, so one could argue it doesn’t matter if ICD-10 is an improvement. But it is better, and perhaps understanding the reasons will ease the pain for practices as they budget and plan for the changeover.
ICD-10 is more logical than ICD-9. According to CMS, the structure in ICD-10 makes it easier to use than ICD-9. Once coders adjust to the new system, finding the right code will be simplified because of the way codes are created. “We ran out of room in certain parts of ICD-9”, states CMS, “So some codes are not where they would logically be placed”. Some other fundamental concepts, like laterality are completely missing from ICD9, so the use of modifiers gets introduced and they also have complex guidelines that are scenario based and confusing to just about everyone.
ICD-10 is more precise than ICD-9. Because there are more codes in ICD-10, it will be more obvious for coders to find the specific detailed code they need, thereby avoiding unspecified codes that are often denied. The new coding system eliminates confusing modifiers and the burden of interpreting ambiguous guidelines. Finally, the specificity and structure of ICD-10 makes it easier for vendors to develop electronic coding tools and software designed to make coders more accurate and billing more efficient.
ICD-10 makes measuring easier. CMS says ICD-10’s wealth of clinical information will mean improved reimbursement methodologies, better ability to monitor public health, and a decreased need for supporting documentation. Enhanced ICD-10 data can be used to design better payment systems, identify fraud and abuse, conduct research, more easily identify candidates for disease management programs, and help providers make more accurate clinical decisions with better outcomes.
ICD-10 is adaptable. According to Medicaid.gov, ICD’s structure allows room for expansion. Unlike ICD-09 which is owned and managed by the AMA, the government will be able to incorporate new procedures and devices as needed, allowing the code set to adapt as technology and science advance medicine and the practice of healthcare changes.
So, take heart. Change is never easy, but it’s always easier to work for a good cause, and the new coding system promises to benefit just about everyone in healthcare, especially the patient.
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