Icd Data Collection Case Study

The structural base for them are not quite the same. The setup for the manual, the formatting of codes and even some of the guidelines are different (not to mention ICD-10-CM has around 70,000 codes while ICD-9-CM has only about 16,000 codes).

Are you and your staff anywhere near ready for ICD-10’s October 1st deadline? Maybe you’ve been overwhelmed just trying to implement all of the other changes happening in healthcare thanks to the Affordable Care Act, EMR mandates, increased Medicare audits, and value-based purchasing penalties; you’ve hardly had time to prepare for this latest coding switch.

The first step in mastering ICD-10-PCS is to become familiar with the terminology, structure and format of this new code set. In addition to the Flash Card software program found on the CD-ROM in the back of the text, AHIMA also offers a deck of ICD-10-PCS flashcards. These high quality flashcards will help you to learn all of the definitions. The full-color flashcards define the 31 Medical and Surgical Root Operations and the

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.

- amount of procedure codes. ICD-10-CM has 71,924 codes compare to 3,824 codes in ICD-9-CM.

The Centers for Medicare and Medicaid Services (CMS) requires all providers to implement ICD-10 coding system begin on October 1st, 2015 so the U.S. healthcare system can communicate in the same language as with other countries’ systems. The transition from ICD-9 to ICD-10 had big changes from 14,000 diagnostic codes to more than 68,000 and 4,000 procedure codes to 87,000. The transition affected the reimbursements of hospitals. Medicare requires all patients’ procedures and services to be coded using ICD-10 system while they are charged in CDM using CPT codes. However, there is no direct link between ICD and CPT codes (Jensen, Ward, & Starbuck, 2016). The CDM committee had to work together to prepare for this event. Switching from numerical

CPT coding is to make sure the patient is getting billed for the correct services that was rendered. The Tabular list is a compilation of codes divided in different categories: Category I, II, III. Category I is the basis of CPT codes. Category II is used for tracing information. Category III is short term codes for collection of services rendered and procedures. There are 15 appendices that are used as guides. Modifiers help report situations. Locating codes are done by finding the main term. Assess information provided such as notes and terms. Locate the code. Guidelines are presented in the front of the sections. Special instructions help point out rules on how to use codes. Instructional notes are located in parentheses

Switching ICD-9 to ICD-10-CM is going to make a huge difference in the medical field! The switch to ICD-10-CM will help with cost reductions, improve quality of care for patients and update the healthcare data the way it should be. One of the major impacts of the switch would be that ICD-10-CM has 65,000 new codes that ICD-9 didn’t have. Having that many more codes means that the detail in each code will be extremely precise and there would be no question on a person diagnosis. The codes are mainly to classify a disease or someones’ major health problem. With ICD-10-CM new codes, they can become precise enough to identify diseases and produces that we were not able to in ICD-9. This is an awesome, huge step in the medical field!

After consideration of public comments, CMS is finalizing their proposal to modify the MS–DRG logic for MS–DRGs 242, 243, and 244 to establish that cases reporting one ICD–10–PCS code from the list of procedure codes describing procedures

The topic of transitioning to the ICD-10 coding system has become a very big issue within the medical practice field. In fact, as of October 1, 2015, all physicians, hospitals, and medical providers are required by the federal government to be in full compliance using ICD-10 coding. ICD-10-CM codes allow for medical providers to provide as much information as possible about the patients state of health and all treatment provided as such. In addition, "The CPT coding system offers doctors across the country a uniform process for coding medical services that streamlines reporting and increases accuracy and efficiency (Ama-assnorg, 2015)."

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.

The conversion to ICD-10 CM/PCS may present challenges initially, but will offer substantial benefits to the APRNs over time. The ICD-9 is developed based on the health landscape 34 years ago, uses outdated technology, lack details, uses antiquated terminology and lacks optimal claim reimbursement whereas, ICD-10 provides a much needed update to medical terminology and disease classification. In addition, ICD-10 will allow APRN to better evaluate patient care, support research initiatives, construct payment systems, process claim, make clinical decisions, observe public health trends, and uncover fraud. Therefore, ICD-10 classification system will support the Advance Practice Nurse more than than the ICD-9 classification

ICD-10-CM/PCS touches on almost every aspect of healthcare systems and processes. Patient access is impacted by ICD-10-CM/PCS in regards to information capture, registration, and medical necessity. The influence on clinical care is with disease and case management, DRG assignment and case mix management, clinical documentation and coding, care guidelines or protocols, and nursing documentation. Billing and financial systems are also affecting for health plan contracting, coding, claims processing, payment policy, and physician reimbursement management. Health information systems impacted include; clinical documentation and coding; electronic health record and CPOE; e-Rx pharmacy and radiology systems; and health exchange integration and support processes. Performance and reporting areas influenced by ICD-10 include: clinical research and registry reporting; performance measurement; audits and fraud and abuse investigation support; quality measures and pay-for-performance; epidemiology and public health reporting.

On October 1st, 2015 ICD-10 (International Classification of Disease) code was set up to take place of ICD-9 codes. It has actually been in the works for several years to make the change. The Change is being required by the Center for Medicare and Medicaid services to provide more specificity to the existing coding system. The ICD-10 uses up to five times as many codes as the former codes of ICD-9 set. This will require more documentation, revised forms, retraining of staff, physicians, and changes in the software. This could require up to sixteen hours of training for coding staff. Structural difference between ICD-9 and ICD-10 are ICD-9 used mainly numeric digits, and ICD- 10 is using alpha and numeric digits. Medical providers had to be ready for a conversion of the new codes which could have to the potential for 140,000 new codes to bill the government and private insurers. .

Very nice project concept with its associated risk factors. ICD-10 is very effective procedure with great details that captured the code sets with more meaningful ways for better understand, design, complications, algorithms and track down the care outcomes for quality patient care (AHIMA, 2008). The used of ICD-10 provide the great detail codes for the medical procedure done by the health care organization for better data evaluation and quality of billing. Similarly, the use of ICD-10 is helpful for both health care providers and patient. For healthcare providers it reduces the need of the supporting document with the use of assign code and for patient it introduces the system that allow only pay for performance program.