Tune in to this monthly online coding column to learn from Melanie Endicott, one of AHIMA’s coding experts, about challenging areas and documentation opportunities for ICD-10-CM/PCS.
I am amazed at how much publicity ICD-10 is getting in the media, and unfortunately it’s not all positive. From Fox News to the Wall Street Journal to You Tube, ICD-10 is a hot topic. Naysayers seem to point out some of the more obscure codes that will likely never be used by many coders in their lifetimes (such as “struck by an orca”), but fail to mention the numerous benefits of ICD-10-CM and ICD-10-PCS.
I am one of ICD-10’s biggest fans and I am hoping to grow my fan club. To be a part of the club, you must be willing and able to tout the various benefits of the new coding system to any and all adversaries. The following is a list of responses you can use when questioned about why the US needs to move to ICD-10.
Why can’t we stay with ICD-9-CM?
- Payors cannot pay claims fairly using ICD-9-CM since the classification system does not accurately reflect current technology and medical treatment.
- Significantly different procedures are assigned to a single ICD-9-CM procedure code, which does not adequately describe the procedure being performed.
- Limitations in the current coding system translate directly to limitations in the diagnosis-related groups (DRGs).
- The healthcare industry cannot accurately measure quality of care using ICD-9-CM since it is difficult to evaluate the outcome of procedures when the codes are imprecise.
- We, as healthcare professionals, have a mission to improve our ability to measure healthcare services provided to our patients, enhance clinical decision-making, track public health issues, conduct medical research, identify fraud and abuse, and design our payment systems to ensure services are appropriately paid.
- ICD-10 provides much greater coding accuracy due to its increased specificity.
- Higher quality information will be available for measuring healthcare service quality, safety, and security.
- Due to the specificity, there is less room for ambiguity in the codes, thus reducing coding errors.
- The conversion to ICD-10 will align the US with coding systems worldwide.
So what’s so great about ICD-10?
An independent study conducted by RAND concluded that the benefits of ICD-10-CM/PCS are likely to exceed initial implementation costs within just a few years. Furthermore, the cost of doing nothing may be greater than the actual implementation. Any delay in adoption of ICD-10-CM/PCS will cause an increase in future implementation costs as the management of health information becomes increasingly electronic and the costs of implementing new coding systems increase due to required systems and application upgrades.
A great resource to share with those that are unfamiliar with all of the benefits and advantages of ICD-10 is a video on the CMS You Tube Channel featuring Sue Bowman, MJ, RHIA, CCS, FAHIMA, senior director, coding policy and compliance at AHIMA.
Please join my unofficial ICD-10 Fan Club today and spread the good news about this outstanding improvement for the healthcare industry!