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.
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.
-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.
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 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.
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
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.
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
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.
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
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
I think transitioning over to ICD-10-CM will make coding easier by being more specific with the descriptions. I think that the biggest challenge is going to be just learning the different sections of the ICD-10-CM. Some other challenges may include training in ICD-10-CM, the cost of the transition, and maintaining two coding systems because some private insurance like workman compensation insurance are not required to switch over to ICD-10-CM. I believe that we have had ICD-9 since 1979 with updates yearly, which makes the ICD-9 over twenty years and almost thirty years old. A lot has changed in the medical world since then and we are due for a change. Anything new will take some time to learn and I believe that the transition would be
Computer-assisted coding is defined as the “use of computer software that automatically generates a set of medical codes for review, validation, and use based upon clinical documentation provided by healthcare practitioners”