What is so great about ICD -10?

This is a guest post about ICD -10 by Laura O’Donnell who writes on behalf of EHR, electronic health record experts at OmniMD.

As of October 1, 2015 the International Statistical Classification of Diseases and Related Health Problems (ICD) is effectively now in ‘round 10.’ This means that all providers covered by HIPAA (the Health Insurance Portability Accountability Act) are required to make the transition from ICD -9 to ICD-10.

It is anticipated that ICD-10’s contribution to precise and meaningful data integration and sharing – across the industry as well as our institutes of research – will further our understanding of medical complications and clarify the connection between a patient’s condition and their physician’s performance.

How does sharing data affect research?

Applying standard ontologies (vocabularies) to organize and leverage the power of shared knowledge across various disciplines has significantly changed the face of research. As regards to this post, the medical industry’s adoption of ICD language has enabled us to discover and react to patterns affecting public health. For example, prognosis research is using data sharing to focus on future outcomes for patients with particular diseases.

Physicians, clinics, hospitals and pharmaceutical companies now combine their respective knowledge with actual patient data. Transparency and accuracy are vital ingredients to ensuring validity, and those workers entering this data are highly skilled and certified by regulatory agencies. When integrated software is used to maximize the power of this linked information, the industry now becomes capable of supporting better treatment decisions and increased credibility of patient results.

What makes ICD -10 so different?

Keep in mind that the ICD -9 was not only outdated (by 30 years), it was inconsistent with current medical practices. In fact, the United States was the final nation with modern healthcare to transition to the ICD-10 diagnosis codes.

Primarily the structure of these new codes is what is so distinctive. Sure, there are more than 65,000 additional variations, and the number of characters has risen from 3-5 characters (with a decimal point) to a combination of 3-7 characters (alpha-numeric). But, it’s the clinical specificity of the code descriptions which has taken this edition of the ICD on an entirely new path into the future.

While ICD-9 was far less effective at monitoring the way resources were used and costs analyzed (and how performance was measured) – the ICD -10 codes have made a remarkable impact on a clinic’s capability to organize the data and operate more efficiently.

What’s so challenging about ICD -10?

Of course when you’ve always done something one way, a mandate to shift everything you do isn’t particularly easy to accept. Some providers began the transition earlier than others. Maybe you waited until the final countdown – maybe not. Bottom line is that ICD -10 is here to stay (at least for a few more generations).

Certainly the new education and training for your staff is going to cost you time and money, but these are ‘necessary evils’ if you want to keep your data on point – and be certain you receive timely payments. Be sure to request verification of ICD -10 credentialed training from new any billing services you may contract for.

Who’s benefiting from ICD -10?

When all’s said and done, the progress made from the ICD -10 transition will be a win-win – for everyone involved. Let’s take a look at what that means to those affected:

  • The Patients – Preventable complications, when identified, can help to prevent them from occurring in the future. External causes of injury (in workplaces and public locations) will be more closely documented – which can improve surveillance as well as design of prevention and control programs. It’s also now more difficult for hospital coders to lump a patient into a severe disease/procedure category (ICD -9 codes were much more vague). There is now more precise reporting for complications from medical devices, breaking them down to the nature of malfunction.
  • The Providers – Added detail on types of procedures allows providers to compare their performance with others in their field. This data can be instrumental in the way a practice distinguishes itself, encouraging the reallocation of resources and promotion of their unique services to patients and others who may refer them. It is also expected that the greater detail inherent in ICD-10 will reduce the documentation previously required to support claims.
  • The Public at Large – Analyzing outcomes and costs, better recognition of trends and added specificity in pinpointing medical complications – these are all improvements in ICD -10 which make a substantial contribution toward public health. As more precise data is collected and added to our national database, it will improve the power to interpret variations, eliminate ineffective procedures and focus on best practices. Reduction of fraudulent use of codes should have a definitive positive impact on the price of healthcare.

Choosing your EHR and EMR systems

Many Electronic Health Records (EHR) and Electronic Medical Records (EMR) vendors make ‘tweaks’ in the software they offer, in order to fit niche specialties. Because the ICD -10 revision is a complete overhaul of the medical codes, your practice deserves a system that isn’t going to fall short (either in your specialty or in general).

Some companies, like OmniMD, specialize in the development of cloud-based medical coding systems and practice & revenue cycle management since long before the Affordable Care Act mandated specific healthcare data collection. Their software has been entirely rewritten – with the input of physicians – and maintains a loyal client following of over 12k providers. They have provided an online taped one-hour webinar explaining the ways in which your practice is affected by ICD -10, and how OmniMD’s EHR/EMR Solution can ensure a seamless transition for your practice.

 

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