Technological advances and increasing medical knowledge can make classifying and coding treatments a complex process. When the World Health Organization introduced the ICD-9 coding system, 13,600 seemed like a lot of classifications. Now, that system has no more room. Plus, some of the inherent weaknesses in the way ICD-9 reports treatments cause confusion between service providers and insurance companies.
Medical coding and billing functions determine when and how much a healthcare provider earns for services. The wrong code can mean a difference of thousands of dollars in a reimbursement. Gray areas may lead to insurance companies denying claims and healthcare providers footing the bill. A newer system, ICD-10, is on target to be launched in October, 2014 with the goal of correcting many of the current issues.
ICD-9 vs. ICD-10
Not only does ICD-9 lack room for new treatments, it also lacks detail in its coding format. When filling out forms for medical billing, you need to be able to distinguish between a first visit and a follow-up, an injury to the right side versus the left and the current state of a disease diagnosis. ICD-10 codes allow for much more information to be included in a single code. Not only does an ICD-10 code differentiate between an initial visit and a follow-up, it also includes subcategories about follow-up visits. A follow-up visit that reveals positive progress has a different code from a follow-up visit revealing complications. This increased specificity reduces the number of requests for clarification from insurance companies.
How Does ICD-10 Add So Many Codes?
ICD-9 uses mostly numeric codes with only occasional E and V alphanumeric codes. Plus, only three-, four- and five-digit codes are valid. ICD-10 uses entirely alphanumeric codes and has valid codes of up to seven digits. This gives ICD-10 approximately 69,000 individual codes, more than five times as many as the ICD-9 system.
The Benefits of Switching to ICD-10
Increased efficiency of medical billing is only one of the benefits of switching to a more data rich coding system. ICD-10 will:
- Allow for better disease tracking
- Track treatment outcomes more transparently
- Streamline reimbursement claims
- Reduce patient confusion
Medical billing and coding schools already offer an introduction to ICD-10. The deadline for switching to the new code system is October 1, 2014. In due time, training in ICD-10 will be mandatory for those in the medical coding and billing profession. This will give future graduates a potential advantage in the market.