It's an exciting time of healthcare reform for the United States and a lot of that excitement revolves around the transition from ICD-9 to ICD-10. If you're asking yourself what is ICD-10 and why it is important, then you've come to the right place.
ICD-10 or a clinical modification of ICD-10 is the classification system currently being used by the majority of the world. The US is the only industrialized nation not using an ICD-10-based classification system.
ICD-10 matters to educators because they are responsible for presenting timely and accurate curriculum to their students so that they are able to successfully utilize the necessary skills and knowledge in the workplace. ICD-10 matters to current and prospective students who are enrolled in programs because they must ensure that their curriculum will prepare them for the changing healthcare environment.
There are two main reasons that the transition to ICD-10-CM/PCS is necessary:
ICD-10-CM is a clinical modification of the World Health Organization’s ICD-10, which consist of a diagnostics classification system. ICD-10-CM includes the level of detail needed for morbidity classification and diagnostics specificity in the United States. It also provides code titles and language that compliment accepted clinical practice in the US. The system consist of more than 68,000 diagnosis codes.
ICD-10-PCS was developed to capture procedure codes. This procedure coding system is much more detailed and specific than the short volume of procedure code included in ICD-9-CM. The system consists of 87,000 procedure codes.
Together ICD-10-CM and ICD-10-PCS have the potential to reveal more about quality of care, so that data can be used in a more meaningful way to better track the outcomes of care. ICD-10-CM/PCS incorporate greater specificity and clinical detail to provide information for clinical decision making and outcomes research.
There are many reasons why the transition to ICD-10 is important. ICD-10 will provide us with:
Additionally the benefits of ICD-10 outweigh the costs.
An independent study conducted by RAND concluded that the benefits of ICD-10-CM/PCS are likely to exceed initial implementation costs within just a few years. Furthermore, the cost of doing nothing may be greater than the actual implementation. Any delay in adoption of ICD-10-CM/PCS will cause an increase in future implementation costs as the management of health information becomes increasingly electronic and the costs of implementing new coding systems increase due to required systems and application upgrades.
There are a number of areas within the ICD-9-CM where the country could benefit from the greater detail provided by having more extensive codes. While there is greater specificity offered in the majority of the ICD-10-PCS codes, there will continue to be options for broader, generalized codes when the specific details regarding a patient's condition may not be known or documented. Additionally, the ICD-9-CM classification has not kept up with medical knowledge. Some examples are as follows:
Example: ICD-9-CM does not accurately reflect current technology and medical treatment. Since ICD-9-CM does not accurately describe advancements in technologies, significantly different procedures are assigned to a single ICD- 9-CM procedure code. Limitations in the coding system translate directly into limitations in coverage and reimbursement.
Example: CMS has had difficulties identifying and paying for new technology. This has been a particular problem in the cardiovascular and orthopedic parts of ICD-9-CM where many categories have no room for more ICD-9-CM codes. Some of the recent problems have included new devices used in spinal fusions, new cardiac defibrillator devices, and drug eluting stents, among others.
It's time to start implementing ICD-10. Choose your position within the education sector to get your ICD-10-CM/PCS implementation needs.
Ensure that students graduating in the ICD-10-CM/PCS implementation year are prepared to pass their credentialing exam and enter the workforce as qualified ICD-10-CM/PCS coders, analysts and managers.
Ensure you will be prepared to pass credentialing exams and enter the workforce in a coding-related role during the implementation time period and beyond the actual implementation date.
Select an academic program that will successfully prepare you to pass credentialing exams and enter the workforce in a coding-related role during the ICD-10-CM/PCS implementation time period and beyond the actual implementation date.