At first glance, the codes within ICD-10 seem almost too detailed. You were bitten by a macaw in your friend's garage and now require medical attention? Documented.
However, ICD-10's specificity should be taken seriously, just as seriously as its implementation deadline of Oct. 1, 2013. Wendy Whittington, MD, chief medical officer of Anthelio Healthcare Solutions, says there are five reasons why providers should not be chuckling at ICD-10. Instead, they should be fully embracing it.
1. ICD-9 is outdated. ICD-9 was developed in the 1970s, and a lot has changed in medicine in the past 40 years. The current system is so obsolete that it has run out of enough codes to describe the detailed work physicians do every day. "It's an entirely different world now," Dr. Whittington says. "We have procedures and diseases now that we weren't thinking about all those years ago."
2. The United States is one of the few developed nations that is still on ICD-9. ICD-10 has been available since 1994, and most other developed nations have already made the conversion, leaving the United States behind the times. The U.S. ICD-10 Clinical Modifications are much more detailed, but Dr. Whittington says it's no excuse the country has lagged so far behind. Australia introduced their first version of ICD-10 in 1998; Canada introduced its ICD-10 in 2000; and several European countries, such as Sweden, France and Germany, have used their translations of ICD-10 for several years now.
3. ICD-9 does not allow for meaningful comparative research; ICD-10 does. Because ICD-9 does not allow physicians to record the true specificity of each patient's condition, it does not let researchers know what the true correct treatment could be, Dr. Whittington says. For example, a patient in California with simple pneumonia and a patient in New Jersey with simple pneumonia for the third time due to particular bacteria are coded as the same thing currently. Both patients might be given the same treatment, but Dr. Whittington says it's hard to treat both patients with the same drug and compare outcomes when the scenarios are, in fact, different. "ICD-10 will allow us to compare apples to apples now," she says.
4. ICD-10 will help clinicians become more effective in documentation. The ICD system, at its core, is a classification system and not a reimbursement system, but because they are intertwined, Dr. Whittington says the new ICD-10 system will justify everything a clinician notates during a patient case. Currently, Dr. Whittington says she will choose a code in ICD-9 that describes a patient's middle ear infection. However, if she sees another patient with a middle ear infection with slight variations but codes it similarly, it might cause payors to question claims. "It's hard as a practicing physician to communicate exactly what I'm doing when I don't have enough codes," Dr. Whittington says. "You'd be amazed at the number of doctors sitting somewhere saying, 'I wish I had a code for this.'"
5. Today's environment leaves little room for more delays. Hospitals are in varying levels of acknowledging the issue of ICD-10 implementation, and putting off the transition to the new system will result in months of lost productivity and reimbursement. "Whether we like it or not, delaying it is really just setting us up for denials and financial problems," Dr. Whittington says. "Physicians have absolutely nothing to lose other than time and sanity now by documenting in a way that is more specific."
Delaying ICD-10 Planning Could Significantly Hurt Hospital Finances
Providers Could Save Time, Money by Implementing ICD-10 and Meaningful Use Together
However, ICD-10's specificity should be taken seriously, just as seriously as its implementation deadline of Oct. 1, 2013. Wendy Whittington, MD, chief medical officer of Anthelio Healthcare Solutions, says there are five reasons why providers should not be chuckling at ICD-10. Instead, they should be fully embracing it.
1. ICD-9 is outdated. ICD-9 was developed in the 1970s, and a lot has changed in medicine in the past 40 years. The current system is so obsolete that it has run out of enough codes to describe the detailed work physicians do every day. "It's an entirely different world now," Dr. Whittington says. "We have procedures and diseases now that we weren't thinking about all those years ago."
2. The United States is one of the few developed nations that is still on ICD-9. ICD-10 has been available since 1994, and most other developed nations have already made the conversion, leaving the United States behind the times. The U.S. ICD-10 Clinical Modifications are much more detailed, but Dr. Whittington says it's no excuse the country has lagged so far behind. Australia introduced their first version of ICD-10 in 1998; Canada introduced its ICD-10 in 2000; and several European countries, such as Sweden, France and Germany, have used their translations of ICD-10 for several years now.
3. ICD-9 does not allow for meaningful comparative research; ICD-10 does. Because ICD-9 does not allow physicians to record the true specificity of each patient's condition, it does not let researchers know what the true correct treatment could be, Dr. Whittington says. For example, a patient in California with simple pneumonia and a patient in New Jersey with simple pneumonia for the third time due to particular bacteria are coded as the same thing currently. Both patients might be given the same treatment, but Dr. Whittington says it's hard to treat both patients with the same drug and compare outcomes when the scenarios are, in fact, different. "ICD-10 will allow us to compare apples to apples now," she says.
4. ICD-10 will help clinicians become more effective in documentation. The ICD system, at its core, is a classification system and not a reimbursement system, but because they are intertwined, Dr. Whittington says the new ICD-10 system will justify everything a clinician notates during a patient case. Currently, Dr. Whittington says she will choose a code in ICD-9 that describes a patient's middle ear infection. However, if she sees another patient with a middle ear infection with slight variations but codes it similarly, it might cause payors to question claims. "It's hard as a practicing physician to communicate exactly what I'm doing when I don't have enough codes," Dr. Whittington says. "You'd be amazed at the number of doctors sitting somewhere saying, 'I wish I had a code for this.'"
5. Today's environment leaves little room for more delays. Hospitals are in varying levels of acknowledging the issue of ICD-10 implementation, and putting off the transition to the new system will result in months of lost productivity and reimbursement. "Whether we like it or not, delaying it is really just setting us up for denials and financial problems," Dr. Whittington says. "Physicians have absolutely nothing to lose other than time and sanity now by documenting in a way that is more specific."
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Providers Could Save Time, Money by Implementing ICD-10 and Meaningful Use Together