For claims to be cleared immediately and reimbursed promptly, it is important to file claims speedily. Detailed diagnoses of condition as well as the treatment given are two very important aspects for processing claims. Filling exact details of diagnosis and treatment can be time consuming and with a view to reduce the workload on the healthcare staff, various codes are created, which are universally accepted by all countries. These codes, known as the ICD Codes, are basically representations of the medical diagnosis and treatment and are used all over the world.
What is ICD 9/ICD 10?
ICD stands for International Statistical Classification of Diseases, which are alphanumeric codes given to various diseases, their diagnosis and treatment. The classification of these codes were initiated and compiled by the World health Organization. The National Center for Health Statistics along with part of Centers for Medicare and Medicaid Services and the World health Organization help monitor the requisite modifications of the codes for United States of America.
These codes help in identifying and recording symptoms, signs, complaints, circumstances and causes of injury or diseases of all patients. These codes are universal across the country, thereby helping doctors understand the exact medical problem of an individual, anywhere in the country. Moreover, these codes are extremely useful when a person is filing a federal insurance claim, whereby he or she does not need to mention in detail the diagnosis and treatment but can only use the specific code and the same will be understood.
History of ICD
ICD or International Classification of diseases as it is popularly known, goes way back to the late 1800s, when the first classification of diseases called the Bertillon Classification was published in 1893. These classifications were reviewed and revised by experts who met every ten years and this venture was supported by the French government. In 1946, the fifth revision of the classification was published, which was done by the World Health Organization. Ever since, the classification has been modified and published by the World health Organization.
The numbers that follow the abbreviation ICD are the versions of the classification. The current version in use is ICD 10, which is, in fact, the tenth version of classification of diseases. Until recently, ICD 9 was being used extensively by doctors. Experts believe that the eleventh version or ICD 11 will soon be published sometime in 2010 but will be implemented only in 2015. It is interesting to note that despite the arrival of ICD 10 codes, most healthcare service providers in the United States are largely using ICD 9 codes for their coding purposes.
Uses of ICD
ICD codes are extremely useful and can be used in the following areas
- ICD codes are useful for recording diagnosis of illness, in addition to recording the symptoms, treatment and medicines. These codes allow for easy recording of all these details, which otherwise would have been a prolonged and time-consuming process.
- ICD codes are extremely useful in identifying the cause of death of an individual.
- These codes help authorities track down diseases, monitor its spread and also help in its control.
- These codes are universally accepted, even internationally, which helps an individual while traveling.
- The codes also help in analyzing the health situation in the country.
- ICD codes help in developing automated systems for decision making for various treatments.
- Lastly, these codes are extremely useful for filing claims as a single code denotes a range of diagnosis, treatment and medicine prescribed, thereby making it easy for the insurer to reimburse the healthcare service provider.
Differences between ICD-9 and ICD-10
Given the importance of ICD codes in recording medical diagnosis, it is important to understand the different versions of codes that are used today. As mentioned before, until recently, ICD-9 was extensively used, which is slowly coming to an end with the implementation of ICD-10 codes by the WHO. Before going into greater details about ICD-10 and its advantages, it is important to understand the differences between the two sets of codes, in order to understand the need for the new version of codes.
- The first difference is that ICD-9 had all numeric codes while ICD-10 uses alphanumeric codes.
- The second difference lies in the fact that codes used in ICD-9 are not very specific as they are numeric in nature and only have a V or E in front of the numbers. ICD-10 on the other hand, being alphanumeric, uses alphabets to define the exact medical problem and is therefore very specific.
- The number of codes that could be added in ICD-9 was limited as the coding system had reached its limit, which is not the case with ICD-10 as this system has built-in mechanisms that enable addition of extra codes.
- Lastly, the ICD-9 did not allow for easy transfer or exchange of information at an international level, which is possible with the ICD-10.
Advantages of ICD-10
Given the limitations of the existing version of international codes for diseases in case of ICD-9, the WHO revised it and brought out the new ICD-10 version, which is purported to solve all problems faced by healthcare service providers using ICD-9. The major advantages of the new ICD-10 are:
- Enhanced accuracy of recording along with greater specifications.
- The new codes are self-explanatory and hence, do not require any translation to be done manually.
- More detailed final health record is now possible with ICD-10, which helps in detailed analysis and better decisions for treatment.
- Better data calls for better decisions for treatment. With the implementation of ICD-10, it is possible for healthcare providers to use the data recorded to take important medical decisions on behalf of the patient, without worrying about the accuracy of treatment.
- Reduction in errors of recording as the coding is very specific and directly relates to the disease or illness.
- Quality control is possible with ICD-10 as the number of errors of recording are considerably reduced, which leads to higher accuracy.
- Faster reimbursements of claims as the forms are accurately filled and quality control is ensured.
- Compatible with international health systems, which enable the codes to be recognized anywhere in the world
- Better patient handling systems are possible, which in turn results in happier patients
- Lastly, improved productivity of staff as less information is required to be fed in.
Monetary impact of ICD-10 on Medical Practitioners and their Practice
Given the myriad advantages of the new ICD-10 system, it is clear that this system is definitely beneficial to any healthcare practice. However, having said that, it is also important to understand the monetary implications of implementing this new system in any facility. Experts believe that implementation of ICD-10 in any healthcare facility will increase the costs in six areas, namely-
- Training and education of the staff who will be using these codes
- Updating the existing IT systems
- Cost of documentation will increase considerably in the new system
- Existing business process analysis, which takes into account coverage, payer contracts and other documentation will also see a rise in expenses
- Superbills is a new feature of this system and there is the necessary cost of updating to this system
- Lastly, the possibility of disruption in the cash flow, which is true for any transition could also occur while changing to the new system.
Health care experts believe that these are costs that are absolutely essential for the transition into the new system of coding. However, in order to ease the financial burden of the healthcare facility, a phased out transition should be considered by the facility, which will not only reduce the costs but will also help the staff build a better understanding of the new system.
Whether a facility uses the old ICD-9 or the present ICD-10 or the newer ICD-11, it really does not matter as the fact remains that automation is in vogue today and healthcare facilities will have to adapt themselves and spend that extra buck, if they want to provide efficient healthcare services to patients.