U.S. Citizens were warned in 2014 that Obamacare came with a new medical billing and coding system. The tenth revision to the ICD (International Classification for Diseases) codes have now been completed in efforts to more thoroughly define diseases and injuries. However, the coding system comes with other changes that are not so exciting. Reportedly, the new ICD-10 codes will require insurance companies to do additional paperwork, which in turn will increase the amount owed by the insured. Patients are not the only individuals being effected by the change.
Doctors and other medical professionals will now have to learn the 140,000 new codes which have been added to describe treatments provided on billing statements as well as private insurance claims. This is a huge leap form the 18,000 codes that previous existed before October 1. The new coding system also requires medical professionals to be very specific in the billing. For example; a doctor must indicate if a broken leg is from a fall, crash, or swing. With the ICD-10 codes taking over 36 years to update, the number of codes to identify a disease or an injury has greatly increased form 8,00o to now 70,000 ICD codes. The question upon the minds of many in the healthcare industry is, was this necessary?
Based on the codes available in the previous medical billing and coding system, ICD-9, the update was indeed needed because new diseases and treatments have been introduced since that system was created. Health Information Management (HIM) professionals disagree with the concerns of medical professionals and consider the update to be a long overdue ease to their work, according to Nature World Report. Recently, HIM Project Manager of Memorial Hermann Health System made a positive statement about the ICD-10 medical billing and coding system.
“The Coalition for ICD-10 is very pleased that the USA healthcare industry can finally begin to leverage the many opportunities anticipated by the availability of better healthcare data – including improved patient outcomes, patient safety, and population health, lower healthcare costs, and adoption of new payment models that reward value.”
With it’s approval by the World Health Organization, the ICD-10 system passed, despite the concerns of medical professionals. One reality that can’t be ignored appears to be research trials of the new system, which has proven that the ICD-10 is flawed. This year, the University of Illinois at Chicago overlooked 24,000 clinical ER encounters and found that one-fourth of them were incorrectly coded due to flawed CMS recommendations. Noticing the errors, one fifth of the claims made since the ICD-10 system has been in place have been denied. Knowing that the first few days of the new system who bring about many problems, one professional, Dr. Richard Thorp warned “Do not got to the doctor on October 1st.” In agreement with Thorp, another professional, Chris Miles of Aon Hewitt Health Group predicts even more problems caused by the ICD-10 system.
“This is a complex conversion that could initially lead to disruptions across the medical field. Providers may see overall delays in claims processing, and some individuals may have insurance claims that are denied for services that were provided, but not properly coded.”
Along with his concerns about the ICD-10 system, Miles also admits to the positives of the medical billing and coding update. Forbes reports that many other medical professionals and healthcare administrators agree with both the pros and cons of the new system.
“Transferring to the new medical claim codes will allow key industry stakeholders to better track and manage diseases, measure the quality of care and evaluate patient outcomes—all of which support the shift toward value-based payment plans.”
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