Medical Codes Are Used For Various Recording And Reporting Purposes Within The Medical Industry

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.

An accurate and specific documentation of universally accepted set of codes are important for the protection of healthcare providers as well as increased reimbursement for services received. These codes are for the validation of which services the patient received from their health care provider ( (Page, 2009). Having the correct codes in place insures the provider with the information needed by the health insurance carrier. Maintained by the AMA (American Medical Association), this universal numeric assignment is also used for developing guidelines for medical care review as well as data collection for medical education and research (Scott, 2013).

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

I do agree with you it will have a great dramatic impact in healthcare. If the coding system is not used in a proper way it can affect many system that uses codes. When using ICD-10 yes this will help to be more specific when it comes to coding. Its not going to be very easy but its is going to help and change the way the coding system is being used so there won't be No mistakes. Yes, there is a big different between ICD-9 and ICD-10-CM but it can be also easy to learn it because it the revision to all the codes. I do believe the change is good because it just going to help us use a specific code when diagnoses.

In order for a patient’s insurance claim to go through correctly, you (as a medical assistant) need to code correctly. In the medical field coding is used to identify diagnoses patient’s have and services provided for them. The codes are then submitted to the patient’s insurance company, so the patient does not have to pay full price for services.

As necessary as ICD-10 is, smaller practices that only have a few physicians on staff will have more of a difficult time integrating the system than larger organizations. The reason being that larger healthcare organizations tend to have coders. Coders are individuals who hardly ever have contact with patients but they are important in the sense that they are the ones that input the ICD codes into patients’ medical records. Without coders, physicians would have to be the ones to input the ICD codes into the patients’ medical record. Luckily physicians at hospitals and other large health organizations do not need to do this. Unfortunately, physicians at smaller organizations do not have coders at their disposal and they are the ones that enter the ICD codes.

The compliance date for implementation of the International Classification of Diseases, 10th Edition, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) was October 1, 2013 for all covered entities. Although, a number of countries that have already converted to ICD-10:

On October 1st, 2015, ICD-10 was implemented and replaced its predecessor, ICD-9, as the standard coding system for the U.S. (Cavitt, 2015). The transformation between ICD-9-CM and ICD-10-CM is that ICD-9-CM had about 14,000 codes and ICD-10 has closer to 69,000 codes. ICD-9-CM was implemented in 1979, where the codes are a standard five-character alphanumeric code to describe diagnoses. “The ICD-9-CM is a Tabular List that is running out of numbers to assign for codes and in some cases, new code proposals could not be adopted because of the limited space” (Hazlewood, 2018). ICD-10 codes give greater specificity to the codes which are seven-character alphanumeric, where every letter of the alphabet is included, except for the letter U. For example, if a patient came to see their physician and they got diagnosed with a high-risk pregnancy the code would be O09.891, showing that the patient has a history of high risk pregnancies and is in her first

The Centers for Medicare and Medicaid (CMS), American Medical Association (AMA), private insurance providers, and a multitude of other healthcare governing agencies have set forth thousands of policies and guidelines that hospitals, nurses, physicians, and even patients must adhere to in order to participate in the healthcare system The politics of healthcare is not limited to within the United States alone. The diagnostic terminology currently in use by America known as the ICD-9. This classification system was created by the World Health organization in 1978, and is considered outdated by many healthcare providers in the US as well other countries around the world. According to the World Health Organization (2015), there are 117 countries that have updated their nosology to ICD-10 and are using this to report mortality data as a primary indicator of health status. The use of ICD-10 by so many other countries has no doubt put pressure on the United States to update out healthcare recording system. It has taken more than a decade, but our country will be changing to ICD-10 on October 1st of this

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. .

The International Classification of Diseases (ICD) is used to supervise the incidence and prevalence of disease and health problems. It proves the general health of countries and other populations. Medical professionals must have an understanding of the standard diagnostic tool for epidemiology health management and clinical purposes which is the International Classification of Disease (ICD). The ICD will be very essential for medical professionals with it being the guide for billing and coding. It will be important for a medical professional to know and understand insurance coding because the codes are a basis for claim information. It is very possible that a medical professional could be assigned to be responsible for diagnostic coding. In

Following HIPAA 5010 will be an impact for health care systems to change to ICD-10 for their medical record coding and billing. “Administrative simplification, speed to market, more automated processes and streamlined project delivery will be strategically important and necessarily balanced with maintaining and enhancing current systems and gaining consumer confidence in health plans.” (Administrative Mandates, 2011)

Computer science, combined with new, more detailed codes of ICD-10-CM, will allow for better analysis of disease patterns and treatment outcomes advancing medical care (aapc.com/ICD-10.) When using the new ICD-10 codes,

ICD-10 a medical classification list went live on October 1, 2015 for U.S healthcare industry after experiencing many lengthy. The adoption of ICD-10 codes offer many more relegation options compared to ICD-9 (Rouse, 2015). With ICD-10 codes, healthcare officials properly document diseases on patient’s charts, government agencies track epidemiology trends, and insurance carriers assist in medical reimbursement decisions. ICD-10 codes are developed by The World Health Organization (WHO) and are adopted by the rest of the healthcare system in the United States.