How ICD-10 will affect your practice

October 10, 2011

October 1, 2013, the way you code your claims will change from ICD-9 to ICD-10.

Because most people do not like change-and it often brings fear-it is imperative that all members staff take an active role in making the changes. Your staff must be prepared and understand that monumental changes are going to take place.

The government mandate for the conversion will affect coding, claims and information technology. With this understanding, a comprehensive assessment of these areas is critical. To ease the fear of the unknown, inform and make sure that your staff members are aware of the progression of this process and have a detailed knowledge of how it will be implemented.

Before you can understand the changes needed to become compliant, it is important to understand the reasons behind the implementation of ICD-10. The transition from ICD-9 to ICD-10 was approved for several reasons, including improved reporting, tracking, and reimbursement.

In addition, ICD-10 allows for more accurate definitions of treatment and specific diagnosis of a broader range of illness and disease, and better classification of the efficiency of new treatments, medications, procedures, and technology for approval of reimbursement. ICD-10 also offers disease management for tracking patients for aid to clinical trials and effective research, and it will help facilitate the gathering of statistical information about medical specificity. Finally, it will provide specificity to lessen rejections.

The reasons for these changes are undeniable. The current system is ambiguous and lacks available codes to address classifications of new diseases. The details incorporated into ICD-10 will allow enhanced disease diagnosis and new treatments. More accurate definitions of treatment and specific diagnoses of a broader range of illness and disease will be possible. The intention is that patients with specific conditions will benefit from tailored disease management programs.

Practices must not assume that they are going to keep using ICD-9 and then map them to ICD-10. The maps are an important tool but will not replace the coding guidelines that must be implemented for the changes occur.

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