What coding systems are used in the United States? "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)
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.
Coding systems are used in the inpatient and outpatient settings for the classification of patient morbidity and mortality information for statistical use. The World Health Organization (WHO) developed the Ninth Revision, International Classification of Diseases (ICD-9) in the 1970s to track mortality statistics across the world. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), is the adaptation the U.S. health system uses as a standard list of six-character alphanumeric codes to describe diagnoses. Globally utilizing a standardized system improves consistency in recording symptoms and diagnoses for payer claims reimbursement, as well as clinical research, and tracking purposes.
Health Information Management Health information management involves the practice of maintaining and taking care of health records in hospitals, health insurance companies and other health institutions, by the use of electronic means (McWay 176). Storage of medical information is carried out by health information management and HIT professionals using information systems
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.
How Will These Changes Affect OB/GYNs? You will be happy to note (that was sarcasm) there are twice as many codes in ICD-10 (2,155) as there were in ICD-9 (1,104). These new codes have been created to allow for more specificity to the characterization of obstetrical conditions. The ICD-10 obstetric codes can be found in Chapter 15 and have sequencing priority over those from other chapters. The codes begin with the letter “O” not the number zero.
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.
A few things are happening soon and for us to be excited about. One is for this Saturday's picnic we will close at 4:30pm as the email stated yesterday. I do hope to see all of you there to enjoy a nice evening by of the family and shorebirds and of course the food!!! We also will be starting to use ICD-10. This is being used all over. From the billing prospective this is a wonderful way of documenting. When we first start this it may take us a few extra minutes with our time patients that have been here before, however; once we do this we will not have to do it again since the codes will then be ICD-10. More information is coming on this.
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.
The main and most obvious difference between ICD-9 and ICD-10 is that there is a significant increase in the amount of codes. ICD-9-CM has an approximate of 17,849 codes when combining all procedural and diagnosis codes, whereas ICD-10 has well over 68,000 Clinical Modification (CM) codes and over 71,000 Procedural Coding System (PCS) codes. There are also several structural differences between ICD-9-CM and ICD-10-CM/PCS. Some of them are:
- amount of diagnosis codes. ICD-10-CM has 69,823 codes compare to 14,025 codes in ICD-9-CM.
Revenue cycle management (RCM) has become increasingly complex thanks in large part to the almost-constant health care reforms and initiatives. As ICD-10 is about to become the new coding standard, hospitals and private practices have begun arming themselves with as many tools and techniques as they can that will help them better manage their revenue cycles.
The International Classification of Diseases, Tenth Revision (ICD-10) has been in development since 1983 to replace the outdated Ninth Revision (ICD-9) that has been in use in the U.S. for over 35 years (Giannangelo, 2015). Due to the Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification regulation published in 2009, the Clinical Modification (ICD-10-CM) will replace ICD-9-CM Volumes 1 and 2, and the Procedure Coding System (ICD-10-PCS) will replace ICD-9-CM Volume 3 for all HIPAA transactions effective October 2015 (Giannangelo, 2015). These new code sets accommodate new procedures and diagnoses and allow for greater specificity in clinical documentation (Centers for Medicare & Medicaid Services [CMS],
ICD-10 – CM is a three- to seven character alphanumeric representation of a disease or condition. The first digit is alpha; Digit 2 is numeric. There is a decimal placed after the third character. There are 69,000 codes to better capture specificity, tis also
The change from: ICD-9-CMS to ICD-10-CMS 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. Problems with ICD-9-CMS were: • Program over 30 years old • Outdated and obsolete terminology • Uses outdated codes that produce inaccurate and limited data • Inconsistent with current medical practice The