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Understanding ICD-10 Coding

The latter end of 2015 saw a significant change in medical coding. The standard ICD-9 (International Classification of diseases, Ninth Division), which had been in use for over three decades was upgraded to ICD-10. This new classification comes with a set of significant upgrades and changes, for example ICD-10 coding uses a wider, seven alphanumeric characters in contrast to the five characters used by the older ICD-9. This alone increases the number of codes from 17,000 to 140,000, thus giving a new edge to medical billing practices.

Significant changes

ICS-10 coding is radically different from ICD-9, since it has undergone extensive changes in key areas such as stands for compliance, coding, reimbursement, documentation, claims, audit protection, procedure codes, diagnostic codes, supply codes, etc. ICD-10 has also amended important information on compliance requirements set up by HIPAA and OIG Audit Program.

Apart from the codes, ICD-10 also had significant changes to the coding guidelines as well. These guidelines explain in detail how these codes ought to be applied and also defined key concepts in the domain. The change in guidelines includes terminology updates, which ought to be incorporated in traditional billing and coding henceforth. Using outdated terminology is grounds for claims dismissal.

Coding compliance

Medicare consultants are getting increasingly uptight about the accuracy of adherence to coding guidelines in medical billing and claims. The guidelines that are essayed in ICD-10 are quite stringent and ought to be complied with at all times. This will help ensure that you get your reimburses on time and without having to spend unnecessary time and efforts in correcting past mistakes.

This is especially important when working with unlisted or unspecified codes. It requires a great deal of dedication and scrutiny to input billing codes that pertain to unspecified procedures/ treatments in order to ensure that the claim is not declined.

It is the responsibility of the clinicians/ physicians to ensure that all the documentation is in good order. Any discrepancies in the accuracy or authenticity of the codes and billing will subject to dismissal of claims.

Developing proficiency

Since ICD-10 has undergone radical changes, even coders proficient in the older ICD-9 will find it tough to cope with the changes. Hence, it is recommended that they undergo suitable training in order to clearly understand the procedural differences in both forms which will enable them to work with utmost efficiency.

This has been a welcome move by most medical billing companies who are now able to offer personalized, quality billing services by doing away with much of the ambiguity that the new system has eliminated. This also means that your coders and billers ought to gain a deeper understanding of anatomy and pathophysiology to match with the extensive reporting in the ICD-10 coding.

This is one of the main reasons why it is recommended that you outsource your medical billing to professional coding services. Getting your in house staff to learn these new codes within reasonable time isn’t much of an option. With a professional team who understands the intricacies of ICD-10 billing and the sensitive nature of strictly adhering to specific codes, you are assured of error free services.


References

  1. Dustman, R. (2016, August 15). 2017 ICD-10-CM Guidelines Released. Retrieved January 11, 2017, from www.aapc.com: https://www.aapc.com/blog/36038-snapshot-icd-10-guidelines-in-2017/
  2. ICD-10 Coding. (2017). Retrieved January 11, 2017, from www.aapc.com: https://www.aapc.com/icd-10/icd-10-coding.aspx
  3. NATALE, C. (2017, January 10). ICD-10 updates revised more than just code sets. Retrieved January 11, 2017, from www.icd10watch.com: http://www.icd10watch.com/blog/icd-10-updates-revised-more-just-code-sets

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