History Of Icd 10 Cm : Coding And Billing

Life expectancy has increased over the last century. With this greater survival rate, there needs to be an increase in the rate of spending for Medicare. Despite what one does to improve their health behavior, the need for medical care cultivates as one ages. This need will continue to increase significantly as medicine continues to modernize.

I was intrigued by the amount of pill bottles that one patient had in his kitchen cupboard which made me reflect on the cost of health care produced by the older adult. I began to research the cost of living longer and found that as of 2011, 24 percent of the Medicare population were over the age of 80. I also found that Medicare spending for those above the age of 85 averages around $14,745 (Neuman, Cubanski, Huaung, & Damico, 2015). So I ended up learning that the older

"In the United States, ICD-10 has been used to classify mortality data since 1999, while we continue to use ICD-9-CM for all other purposes, such as billing and morbidity statistics. In addition, government agencies, health care insures, and providers are studying the implications of switching to ICD-10-CM." (Aalseth, 2006)

Baby boomer aging is one of the large causative factors of this increase in demand (Glicken & Miller, 2013, p.1883-1889). According to Glicken & Miller (2013), the elderly population will nearly double in the next fifteen years putting a strain on the healthcare workforce. Also, more than half of physicians have intentions on limiting care access with regards to Medicare patients. Many medical doctors are refusing to care for Medicaid patients. This is a result of the growing number of individuals now with the means to afford healthcare due to the

As this baby-boomer generation continues to age there will be profound effects on the way that money is spent on health care and insurance. With approximately 77 million people turning 65 over the next several years, the amount of government spending on Medicare will greatly increase (Gigante, 2012). Thus, the demand for medical care associated with the aging population will so

One dominant economic feature of the healthcare industry is the growing need for both basic and specialized healthcare due to the continued aging of the “Baby Boomer” generation. This generation consists of over 79,000,000 individuals born in the US between 1946 and 1964. As this generation has aged, the need for healthcare has increased dramatically. Let us take a look at some statistics:

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.

It is widely believed that the aging of the U.S. population is a major driver of the annual growth in the demand for health care and in national health spending

Medical coding, on the other hand, deals more closely with patient medical records. Medical coders work in the billing office, or “back office” of medical practices or hospitals. Alphanumeric codes are assigned to all illnesses, injuries and treatments. Medical procedures are coded for the purpose of classifying diseases in numerical sequences for identification and data collection purposes, similar to the Dewey Decimal System in libraries. Coding specialists review medical records and assign numeric codes for the diagnoses identified and procedures performed. Each medical procedure and patient encounter has a number (CPT code) associated with it which corresponds to an ICD code. These

In 1978, the World Health Organization published ICD-9. It was later modified by the US Public Health Service so that it could service the needs of American hospitals. This modification was named International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM). As of October 1, 2015, ICD-9-CM was replaced with ICD-10-CM. ICD-10-CM was considered an upgrade from ICD-9-CM because it was more specific and contained many more codes than its predecessor. Most of the categories contained in ICD-9-CM were completely full with no room for expansion. ICD-10-CM goes into a lot more detail than ICD-9-CM. ICD-10 has been upgraded to contain up to seven digits as opposed to the four to five that were associated with ICD-9.

➤ Diagnosis classification system developed by the Centers for Disease Control and Prevention for use in all U.S. health care treatment settings. Diagnosis coding under this system uses 3–7 alpha and numeric digits and full code titles, but the format is very much the same as ICD-9-CM

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.

This stream of research eventually developed into a dedicated discipline, Artificial Intelligence in Medicine (AIM), with wide appeal and broad consensus for optimism. In 1970, Schwartz announced in the New England Journal of Medicine that clinical computing would likely be commonplace in the “not too distant future.” The use of computerized clinical information systems to support hospital operation as well as clinical activities started to flourish in the early 1990s. Besides the significant technological breakthroughs, including the availability of enterprise-level database management systems (DBMS) and health data standards such as ICD and HL7, new legislation and advocacy by federal funding agencies also played a key role. International Statistical Classification of Diseases: Standard diagnostic classification developed by the World Health Organization (WHO) for its member states to report mortality and morbidity statistics. In the United States, ICD-9-CM (ICD 9th Revision, Clinical Modification) is widely used to codify diagnostic data for administrative (such as billing) purposes. http://www.cdc.gov/nchs/datawh/ftpserv/ftpICD9/ftpICD9.htm. Health Level Seven (HL7) is an all-volunteer, not-for-profit organization. It oversees the development of international health data exchange standards. http://www.hl7.org. Financial investments to implement large-scale health IT systems were made by the Agency for

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,