World Health Organization (WHO) usually publishes and updates standardized codes for classification of medical procedures and terminologies to be used by medical fraternity worldwide. When it comes to morbidity and mortality statistics, the International Classification of Disease 10th Procedure Coding System (ICD-10-PCS) is used. The system relies on three to seven alphanumeric for specification of medical procedures.
The code consists of between three to seven digit alphanumeric codes all specifying the procedure. The first digit of the code is used to indicate the area of medical practice such as monitoring, measuring, surgery and administration among other. The rest of digits indicate the body system, the root operation, the body part, the approach used and the devise used in the procedure. The seventh character is the quantifying digit.
The ICD-10 came as a replacement of the ICD-9 and is set to take effect on October 1, 2014 bringing with it a dramatic change in medical and healthcare sector in general. All the players from federal government, state governments, medical professionals and the insurance firms are set to be affected by this new coding system.
While the ICD-10-PCS are used for in-patient procedures and studies, the same cannot be used when it comes to billing of the radiologist professional components. They are also not applicable for procedures and studies concerning out-patients. The implication is that this coding system describes the procedures that are performed on in-patients but the identical procedures performed on out-patients are still described by the original CPT codes.
The auto insurance industry, legal claims and workers comps will not be converting to the new ICD-10 codes forcing hospitals to provide a mixture of CPT, ICD-9, ICD-10 and ICD-10-PCS in general management and billing system. For this reason, every player should have the capacity, ability and knowledge on when to and how to automatically convert from one coding system to the other and back. This should also be done with ease, efficiency and comfort as much as possible.
Given that some players like the auto insurance, legal claims and workers comps are not expected to convert to the new coding system, the hospitals are likely to use CPT, ICD-9, ICD-10-CM and ICD-10-PCS all at the same time. This calls for capacity evaluation, ability training and general knowledge in the part of healthcare providers to keep up to the demand of converting from one coding system to the other and back in an efficient and easy manner.
If you choose the option of upgrading the system as required, there are a few challenges that you need to prepare for as suggested by studies done on countries that have already converted to the new coding system. These include increased time per claim for coders, need to additional staff, concurrent processing of ICD-9, 10 and the new in-patient code, disruption of reimbursements and possible backlog of programming requests.
There are several benefits that come with early compliance such as being able to avoid confusion and delays as all other players seek to comply at last minute. In fact, this is likely to cause system backlogs. The transition to the ICD-10-PCS may not be as smooth as expected especially if the rumors and concerns arising are not fully addressed. The major concern comes from rumors that unspecific codes will be eliminated making it impossible to make claims for the related complications.
The code consists of between three to seven digit alphanumeric codes all specifying the procedure. The first digit of the code is used to indicate the area of medical practice such as monitoring, measuring, surgery and administration among other. The rest of digits indicate the body system, the root operation, the body part, the approach used and the devise used in the procedure. The seventh character is the quantifying digit.
The ICD-10 came as a replacement of the ICD-9 and is set to take effect on October 1, 2014 bringing with it a dramatic change in medical and healthcare sector in general. All the players from federal government, state governments, medical professionals and the insurance firms are set to be affected by this new coding system.
While the ICD-10-PCS are used for in-patient procedures and studies, the same cannot be used when it comes to billing of the radiologist professional components. They are also not applicable for procedures and studies concerning out-patients. The implication is that this coding system describes the procedures that are performed on in-patients but the identical procedures performed on out-patients are still described by the original CPT codes.
The auto insurance industry, legal claims and workers comps will not be converting to the new ICD-10 codes forcing hospitals to provide a mixture of CPT, ICD-9, ICD-10 and ICD-10-PCS in general management and billing system. For this reason, every player should have the capacity, ability and knowledge on when to and how to automatically convert from one coding system to the other and back. This should also be done with ease, efficiency and comfort as much as possible.
Given that some players like the auto insurance, legal claims and workers comps are not expected to convert to the new coding system, the hospitals are likely to use CPT, ICD-9, ICD-10-CM and ICD-10-PCS all at the same time. This calls for capacity evaluation, ability training and general knowledge in the part of healthcare providers to keep up to the demand of converting from one coding system to the other and back in an efficient and easy manner.
If you choose the option of upgrading the system as required, there are a few challenges that you need to prepare for as suggested by studies done on countries that have already converted to the new coding system. These include increased time per claim for coders, need to additional staff, concurrent processing of ICD-9, 10 and the new in-patient code, disruption of reimbursements and possible backlog of programming requests.
There are several benefits that come with early compliance such as being able to avoid confusion and delays as all other players seek to comply at last minute. In fact, this is likely to cause system backlogs. The transition to the ICD-10-PCS may not be as smooth as expected especially if the rumors and concerns arising are not fully addressed. The major concern comes from rumors that unspecific codes will be eliminated making it impossible to make claims for the related complications.
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