The International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), is a unique coding for diseases, signs and symptoms, external causes of diseases, as maintained by the World Health Organization. By translating disease diagnoses and other health-related problems into an alphanumeric code, the ICD permits systematic recording, analysis, and interpretation of mortality and morbidity data collected in different countries. The code set allows more than 14,400 different codes that allow the tracking of new diagnoses as well.
National Healthcare Anti-Fraud Association cites that anywhere between $70 billion and $234 billion is lost annually to health care fraud, mostly concerning the medical billing industry. The specific coding manipulations of ICD-10 will help in preventing these manipulations to a large extent. Focusing on improved quality of health care, ICD-10 will replace ICD-9 on October 1, 2013 in the United States.
The Difference Between ICD-9 And ICD-10
Although the purpose of both ICD-9 and ICD-10 revisions are the same (promoting international comparability in collection, processing, and classification of mortality statistics) the differences between the two versions are significant. The major differences between ICD-9 and ICD-10 include:
• Improved quality of healthcare: ICD-9 contains numeric codes of three to five digits; it is more generic in its approach and does not reveal the exact health condition. ICD-10 consists of alphanumeric codes of three to seven digits and is more specific in its approach, which helps in efficient disease management and in preventing manipulation by the medical billing industry.
• Easier sharing of medical information: Because most countries follow the ICD-10, it would be easier to share medical information across borders. Collaboration would also help in sharing the best practices related to the medical domain.
• More accurate: ICD-10 increased character length, expanding the number of codes available for use. It also provides plenty of space to add new procedures.
As ICD-10 prepares to replace ICD-9, the change in code specificity and increase in number of codes would require the medical industry to plan and train for the transition. Significant knowledge and investments in this new version certainly would change the health care sector’s efficiency.
Impact of ICD-10 on Health Care Reforms
Much greater clinical detail in ICD-10 and specific disease classifications will not only result in more timely reimbursements but would also account for better quality of patient care.
Some of the benefits of ICD-10 include:
• Strategic planning of healthcare systems: Enables storage and retrieval of diagnostic information for clinical and quality purposes; aids in compilation of national mortality and morbidity statistics.
• Preventing frauds related to medical billing: ICD-10 ensures more accurate and timely reimbursements. The accurate classification of diseases also helps in detecting health care fraud and abuses.
• No more pre-existing conditions: ICD-10 is expected to eliminate discrimination based on pre-existing health care conditions and help in easing the approval process for medical coverage.
What this Means for the Medical Coding Industry
The efficient coding system of ICD-10 will drastically change the way health information is classified, providing an efficient way of capturing data. The increase in the number of insured individuals coupled with the more efficient data system will mean more jobs and opportunities for the coding professionals and more efficient and cost-effective health care for the public.