6 mins read
August 17, 2020
The International Classification of Diseases (ICD) was established by the World Health Organization to standardize medical records. Guess what? Now, the version ICD-9 coding was replaced by new version ICD-10-CM/PCS to modernize the medical coding pattern and adopt with the latest changes in today’s advanced healthcare marketplace.
The U.S healthcare industry made the switch to ICD-10 for coding, classifying, diagnoses, and procedures. This ICD-10 transition had drawn much speculation and confusion as it represented a momentous effect on healthcare providers, payers, and billing companies. You may be familiar with the expansion of new codes and changes with the coding structure. However, the impact of ICD-10 is a must thing to know about, and here is the evolution of ICD -10 coding and how it has impacted the healthcare industry.
WHO introduced the ICD-9 medical billing codes system (International Classification of Diseases-9th Edition with U.S. Clinical Modification – CM) in the year 1977 to help codify mortality and morbidity data for various diseases around the globe. By giving specific codes for diseases, injuries, and medical conditions, physicians could able to easily categorize the various services they administered to their patients. And this helps to justify the medical expenses billed on insurance claims. Later the ICD- 9 frameworks were modified for use in the U.S in the year 1979 and named as ICD-9-CM. This coding system had replaced all others used by American hospitals. By 1998, all U.S. doctors were required to utilize the ICD-9-CM codes to present their medical claims.
The WHO developed the ICD-10 billing codes system in the year 1993, a substantial upgrade from the ICD-9 design. At the time of release, the ICD-10 coding system was quickly accepted by almost all countries around the globe except the U.S., as they continued to utilize the version ICD-9 model.
The ICD-10 classification system is effective in the U.S. from October 1st, 2014. This coding system is more advanced and comprehensive than the previous versions. To issue the appropriate codes for the medical coders and the billers in the billing process, ICD-10 requires the doctors to be much more specific in their documentation of treatments.
The ICD-10 has created a tremendous impact in the U.S market on how documentation is handled by both medical professionals and the coding profession. Today, it’s medical billing and coding professional’s responsibility to find the appropriate diagnostic and procedural codes for billing purposes. So the coders and billers should be updated with the ICD-10 coding system, methodologies, and tools to continue to provide the high level of performance required for their profession.
With the introduction of ICD-10 codes, the total number of medical codes were expanded from 14,000 to 68,000 in ICD-10-CM and from 4,000 to 87,000 in ICD-10-PCS. Here are the top 3 comparisons of ICD-9 vs ICD-10.
The number of codes in ICD-9 was approximately 16,000 and the coding structure made it impossible to add to this number. So as medical technology advanced, ICD-9 remained too complex to keep up. Here comes the new coding structure to adopt the new data collection.
For example, instead of stating in simple words ‘ A patient has a back pain’, you can be even more specific as to what kind of back pain a patient has and where. ICD-10 creates incredible benefits for doctors in building a history for patients that will also benefit them as they seek medical help later in their lives.
As discussed previously in the benefits section of ICD-9, it has many effective capabilities, but ICD-10 can generate even more comprehensive data that can be analyzed on a global level. This is important information that can be used to track diseases, prevalence rates, and other purposes.
ICD-9 didn’t have any facility to include bespoke codes or report unsupported diagnostic outcomes, which is something ICD-10 does quite well. In the regular course of patient experience, specialists will regularly confront diagnostic situations that are beside the point. This created a great challenge with ICD-9 as the specialist needed to approximately go with the nearest code related to the condition. With ICD-10, the new framework supports custom codes, which the specialist can input and later support with documentation during assessments.
Upgrading to the ICD-10 coding system in medical billing will enhance medical coding practices in the U.S. and place the country on par with other countries around the world. In like manner, medical coders and billers can upgrade their services to the medical profession by taking advantage of the advanced technology provided by the top professional coding services.