Lag Days Research Paper

Coders has to make sure they are putting the decimal in the right place for proper ICD-10 codes in order to get the correct diagnosis. Example Pain in gallbladder K82.9 If it looked like K82 as a coder we would know this not correct and would cause a issue with getting this paid,or the computer kicking it back with error.

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.

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.

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

-Inpatient coders have certifications allowing them to work exclusively for hospitals or facilities. An expertise in medical record review is a must, along with an up to date status with coding rule changes, regulations and issues for medical coding, reimbursements and compliance under MS-DRG and Inpatient Prospective Payment Systems (IPPS). Coders should have experience as well as expert knowledge in abstracting information from medical records for ICD-9CM vol. 1-3, specialized payment in MS-DRG and IPPS.

The United States implemented the current version (ICD-9) in 1979. ICD-10- CM is the mandated code set for diagnoses under the HIPAA Electronic Health Care Transactions and Code Sets standard starting on October 1, 2014. While most countries moved to ICD-10 several years ago, the United States is just now transitioning into ICD-10 and has to be compliant by October 1, 2015. ICD has been revised a number of times since the coding system was first developed more than a hundred years ago.

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

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.

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.

ICD-9-CM contained procedural codes in volume 3, ICD-10-CM does not contain any as they are now implemented within ICD-10-PCS..More conditions require multiple coding in ICD because it has fewer combination codes than ICD 10 cm I spent 1 hour 30 minutes reading the book and Plus I watching videos of ICD 9 cm and ICD 10 cm

Before discussing the implementation process of ICD-10 it is imperative to understand the differences between ICD-9 and ICD-10 coding and the reason for the transition. The new ICD-10 coding has over 69,000 codes to identify diagnoses compared to 14,000 in the ICD-9 coding version. The increasing number of codes will aid in specificity of all diagnoses. Every diagnosis has a specific code identity. The code identity for the ICD-10 coding is made up of seven digits whereas ICD-9 coding has only three to five digits for each diagnosis. These digits are numbers used to explain a specific injury or procedure. Behind each diagnostic code is an exclusion wording. It gives the diagnosis code in specific detail of the exact diagnosis the physician

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

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.

Medical Coding involves the records of the patients. Medical Coders are responsible for getting all the patients information and records from the office staff, that is how the coding process

As viewed by many HIM professionals Computer-assisted coding is a valuable tool for enhancing the effectiveness of coding and billing. CAC software scans medical documentation in the electronic health record (EHRs) using a natural language processing (NLP) engine, identifying key terminology and proposing codes for that specific treatment or service. Human coder then revised these codes. CAC can also investigate the background of key words to conclude whether they need coding.