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ICD-10 – A Brief Understanding

Feb 28th 2014 at 3:41 AM

With October 1, 2014 set as the deadline, US Healthcare Entities are working like the Trojans towards the ICD-10 medical coding implementation. Despite their busy schedule involving medical coding services and patient care services, many healthcare entities have started devoting time to this transition. However, there are few Providers and medical coding companies, who do not understand the importance of the ICD-10 medical coding implementation. This is an attempt to provide a brief understanding on the basics of ICD-10:

ICD-10 Medical Coding – An Overview: At present, medical diagnoses and hospital inpatient procedures were reported using the ICD-9 code set. This ninth revision of the ICD-9-CM is the US version developed by NCHS and CMS based on the WHO codes. Of the 3 volumes, the ICD-9 code set contained the codes for reporting diagnoses and symptoms in the first two and the codes for reporting in-patient surgical & non-surgical procedures in the third. As it failed to provide sufficient data on patients’ medical conditions and inpatient procedures, the ICD-10 medical coding set came into focus with an inclusion of over 200,000 new codes.

ICD-10 medical coding has two parts:

· ICD-10-CM: Replacing ICD-9-CM volumes 1 and 2, this diagnosis code set will be used for all US healthcare settings. It uses 3 to 7 digits, instead of 3 to 5 digits as in the case of ICD-9. However the coding format is similar.

· ICD-10-PCS: Replacing the ICD-9-CM volume 3, this code set is used only in in-patient hospital settings. It uses 7 alphanumeric digits instead of 3 to 4 as in the case of ICD-9. The ICD-10 procedural medical coding is much more specific and different from its former version.

The need for Transition: More than 30 years old, the ICD-9 code set contains outdated coding terms and strategies, which do not comply with current healthcare trends. Therefore, WHO decided to adopt a new code set that would be more specific in enhancing diagnoses, reporting, and payment processes. The ICD-10 medical coding services eliminate the complexity of coding involved in the ICD-9 code set.

Benefits of ICD-10 Medical Coding: Even though Providers and medical coding companies face a tough time implementing the ICD-10 code set, they are happy with the numerous benefits it provides. The ICD-10 medical coding set clearly reflects current healthcare diagnosis trends and technological advancements. It also helps in confronting unexpected bioterrorism events and epidemic outbreaks. To sum up, this code set enhances patient care, public health reporting, and data benchmarking while reducing claim denials to a maximum.

Things to Note:

· Right from Providers and Payers to clearing houses and medical coding companies, everyone who is covered by the HIPAA (Health Insurance Portability and Accountability Act) must comply with ICD-10 transition.

· They must have adopted the HIPAA 5010 platform to perform all electronic transactions. Only 5010 standards accommodate ICD-10 code sets. This has already been adopted in 2013.

· Claims with ICD-9 code set will not be paid after the compliance deadline.

One of the prudent ways to minimize risk during this transition is to work with medical coding companies that are based offshore.

About e-Care India:

ecare India is one of the renowned offshore medical billing companies in India that has AAPC certified coders with ICD-10 certifications. With 14 years of experience in the industry, e-Care’s 3 offshore medical billing delivery centers have been providing full medical coding services and end-to-end medical billing seamlessly to its clients. To know more about e-Care and its services, log on to ecareindia.com.

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