Summary: What is ICD-10? Why do we need it? What are the shortcomings of ICD-9? When is the implementation date? How do you comply?
Previous blogs on ICD-10
Will You Be Ready for ICD-10 – Deadline Extended to October 1, 2014: https://bhmpc.com/2013/01/will-you-be-ready-for-icd-10-deadline-extended-to-october-2014/
What is ICD-10?
ICD-10 is a diagnostic coding system implemented by the World Health Organization (WHO) which is used by almost every country in the world, with the exception of the United States. ICD is the abbreviation for the Internal Classification of Diseases, 10th Revision. The US has opted to adopt ICD-10 to replace ICD-9 effective October 1, 2014.
Why do we need ICD-10?
- We are running out of new codes which can be generated.
- The current structure is limited to mostly numeric values, using 3 digits as the main classifier, and a combination of 10 digits.
- Most numbers in most categories have been already been assigned diagnoses, leaving no room to try to maintain the current structure let alone assign codes for new diagnoses.
- Medical science is constantly discovering new diagnoses and there just aren’t enough codes to accommodate the growth.
- The system is almost obsolete in terms of remaining current with today’s treatment, reporting and payment processes. It hasn’t kept up with the times. One example is medical terminology. ICD-9 has not remained current in terms of medical terminology.
- Organization of codes
- Anyone qualified to code ICD-9 should be able to make the transition to coding ICD-10.
How do you implement ICD-10?
AAPC has created an implementation plan as well as an automated method for tracking progress. The implementation plan is very detailed, outlining tasks from 2012 to 2014. The automated tracking allows organizations to see how they are progressing on their implementation plan. AAPC’s system is setup with red, green, and yellow lights to provide a very quick view of the areas in which progress is coming along nicely and those areas in which the organization is falling behind the deadlines and needs to step up the pace. To view the ICD-10 information on the AAPC website, please visit: http://www.aapc.com/icd-10/index.aspx. There is a wealth of information available on this site including topics such as: implementation, training, documentation issues, readiness assessment, and mapping between ICD-9 and ICD-10.
Training is going to be key. Anyone who has anything to do with coding – from coders to practice managers, to billers, to physicians and other healthcare personnel – all of these individuals will require training on ICD-10. Some of the training areas may include: anatomy and physiology, specialty ICD-10 code set training, and proficiency assessment. The good news is that anyone who is certified to code for ICD-9 should be able to adapt to ICD-10.
So, what happens if you don’t comply with ICD-10 by October 1, 2014?
Any ICD-9 codes which are submitted for transactions for services or discharges occurring on or after October 1, 2014 will be rejected – not processed. This will cause major issues in terms of reimbursement and payment. That is pretty severe. So, you need to make every effort possible to comply with the deadlines set. The profitability of your organization depends upon it.
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