The medical community has officially started using ICD-10 or the International Classification of Diseases 10th revision, the new code set aims to assist doctors, nursing homes, hospitals and insurance companies in timely payments to providers and reducing fraud.
The switch from ICD-9 to ICD-10 is mandatory in all medical providers in the United States. The U.S. has been using ICD-9 since 1979 and has 14,000 codes for medical conditions and procedures. The revised version, ICD-10 has been endorsed by the World Health Organization (WHO) first in 1990. The jump from 14,000 codes to 69,000 codes is a bit feat for all medical providers but the improvement is geared towards better understanding symptoms, ailments and procedures to detect epidemics.
The ICD-10 is more complex and detail-oriented. For example, when a patient comes in and the diagnosis is a broken arm, medical providers need to determine which arm was broken and its cause before selecting the right code.
The ICD-10 quest level of specificity can be misconstrued as comical. Classic examples include nine different codes for turkey bites. Doctors and healthcare providers need to determine if the patient was pecked or struck by the bird because there are two different codes for the same turkey attack.
The switch from ICD-9 to ICD-10 is just as expensive. A 2014 study from the American Medical Association revealed that a small medical practice can spend $56,639 to almost $226,105 to update and switch to the new system. A large practice can spend as much as $8 million. These cost estimates have resulted in many companies getting loans in the past years.
The launch of ICD-10 has its share of pessimists and optimists. Supporters said that the more specific codes will help the medical community to be more accurate. For instance, insurance claims will become more precise. As for the pessimists, the chances of wrongdoing that could happen from the doctor's office to the insurance company will be more prevalent.
Medicare claims with wrong codes won't be denied for a year when the ICD-10 switch takes place, said Centers for Medicare and Medicaid Services. As long as the claims are in the right family code, the providers will get their payment and will not face penalties during the transitional year.
