A Comparative Analysis Of ICD-10-CM (PCS)

ICD-9-CM codes could before be labeled in just one code, now with more clinical detail to sort through, ICD-10-CM have many more codes to choose from that are much more detail oriented and specific.

Coding systems are used in the inpatient and outpatient settings for the classification of patient morbidity and mortality information for statistical use. The World Health Organization (WHO) developed the Ninth Revision, International Classification of Diseases (ICD-9) in the 1970s to track mortality statistics across the world. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), is the adaptation the U.S. health system uses as a standard list of six-character alphanumeric codes to describe diagnoses. Globally utilizing a standardized system improves consistency in recording symptoms and diagnoses for payer claims reimbursement, as well as clinical research, and tracking purposes.

There are two trends that I have learned about from UMA and TV. ICD-10 replacing IDC-9. ICD-10 will provide the medical billing/coder with more descriptions for describing encounters and hospital stay for patients. Where ICD-9 had 3,824 procedure codes and 14,025 diagnosis codes, ICD-10 on the other hand, has 71,924 procedure codes and 69,823 diagnosis codes that is a big difference. The affordable care act also made an impacted on billing/coding since more people are getting procedures done. These procedures will need to be coded and documented for doctors and hospitals to get paid.

The continue use of ICD-9 codes after the effective date could result in the denial of reimbursement claims. This task can be assigned to the healthcare organization’s management team to determine a solution avoiding a break down in the system. Rahmathulla states, “In instances of an audit, appropriate documentation will make the query process substantially easier while enabling coders to clarify issues without having to query the provider multiple times for answers” (“Migration To The ICD-10 Coding System S187). It is important to accurately document to reduce the amount of claim denials. With the new specificity requirement of the ICD-10 and documentation supporting a claim, lowers the chances of healthcare fraud. The healthcare management team will oversee the process to prevent the risk of exposure.

A few things are happening soon and for us to be excited about. One is for this Saturday's picnic we will close at 4:30pm as the email stated yesterday. I do hope to see all of you there to enjoy a nice evening by of the family and shorebirds and of course the food!!! We also will be starting to use ICD-10. This is being used all over. From the billing prospective this is a wonderful way of documenting. When we first start this it may take us a few extra minutes with our time patients that have been here before, however; once we do this we will not have to do it again since the codes will then be ICD-10. More information is coming on this.

I am choosing ICD-10 Codes. The reason I have chosen ICD-10 codes is because every medical facility uses the ICD-10 codes for the billing and coding. That is the only way they get paid is by using ICD-10 codes. They will all receive adequate payments using the updated codes and the right type of billing.

ICD-10 is a huge change from ICD-9, the main purpose was to help coders code more specific. One benefit of ICD-10 is to give the doctor an electronic trail of proof for payments from patients, insurance, government, and hospitals. ICD-9 having diagnosis codes ranging from three to five digits but ICD-10 having diagnosis codes ranging from three to seven digits will automatically give you a more detailed code. Using ICD-10 gives you a lesser risk of getting audited. Giving a specific description on claim forms will make it harder to get the wrong code. ICD-10 will improve healthcare, the codes are more detailed making the data and communication flow faster. ICD-10's will help guarantee the physician reputation; the electronic trails are reported

The main and most obvious difference between ICD-9 and ICD-10 is that there is a significant increase in the amount of codes. ICD-9-CM has an approximate of 17,849 codes when combining all procedural and diagnosis codes, whereas ICD-10 has well over 68,000 Clinical Modification (CM) codes and over 71,000 Procedural Coding System (PCS) codes. There are also several structural differences between ICD-9-CM and ICD-10-CM/PCS. Some of them are:

- amount of diagnosis codes. ICD-10-CM has 69,823 codes compare to 14,025 codes in ICD-9-CM.

ICD-10 – CM is a three- to seven character alphanumeric representation of a disease or condition. The first digit is alpha; Digit 2 is numeric. There is a decimal placed after the third character. There are 69,000 codes to better capture specificity, tis also

Having the lack of knowledge of the ICD-10 coding will not only affect our patients care from longer waiting time for authorizations to even denials. I also believe that it will affect the revenue that we receive into our facility from the insurance companies. Judith Veazie (October, 2014) author of the article “Creating an ICD-10 Training Strategy” states that no matter what field of healthcare you are in you will be affected by the current change to ICD-10. This new system provides better ways to submit your insurance claims for processing for reimbursement if coded properly. Veazie also says the benefit of ICD-10 is the specific amounts of codes that are now available to us which in return will be a benefit to our patients and facility.

One God vine in the ICD-9-CM official coding is the level of detail that is in Coding.according to the book the diagnosis and procedure code should be used at the highest number of digits that are available this means that the diagnosis codes are made up of 3,4,or 5 digits. And ICD nine coding the first three digits are the heading of the category code and the fourth and fifth digits provide the details of the code. If the court does not have the correct number of digits it is therefore rendered invalid. And example from the book that was given would be acute myocardial infarction. In this example the first three digits 410 provide the heading or diagnosis. There's also a fourth digit present that describes the location of said infarction the

Due to ICD-9-CMS’ ability to provide necessary detail for patients’ medical conditions or the procedures and services performed on hospital patients, ICD-10-CM/PCS was implemented.

ICD-10, which is the tenth revision of the International Statistical Classification of Diseases and Related Health Problem, refers to a medical classification inventory for the coding of diseases, their signs, symptoms and causes (Center for Disease Control and Prevention 1). The use of this revised version in the United States is scheduled to begin officially on the first of October 2013. Currently, ICD-10 is being used for diagnosis coding, in procedure coding systems and for inpatient procedure coding.

The outmoded coding professional’s role was to describe and apportion diagnosis, procedure, and other medicinal service codes using ICD-9-CM and HCPCS/CPT coding classifications while referencing the Coding Clinic for ICD-9-CM, Coding Clinic for HCPCS,