The official conversion to ICD-10, with the mandatory compliance date of October 1, 2015, is the first time we have seen an update to the coding system here in the U.S. in 35 years.
While the increase from 19,000 diagnostic and procedure codes to 142,000 may have some medical billers cringing, the change comes with a great many long-term, big-picture benefits.
For starters, the new codes will generate more granular data that can lead to improved patient safety and outcomes. According to the American Health Information Management Association (AHIMA), “ICD-10 improves the accuracy of claims, quality of care, and patient safety. It makes managing population health and conducting clinical, health services, or translational research easier.”
That is just the beginning of where ICD can help patients. It can also help them, as well as providers, anticipate and understand the upfront costs of various treatment options. Additionally, it can help get estimates out and bills processed more quickly.
For example, instead of a code indicating “torn anterior cruciate ligament,” there are now separate codes indicating whether, for example, it was of the right knee or left knee, and whether it was the first doctor visit corresponding to the injury, or a subsequent one. In other words, the new system, in the words of Lynne Thomas Gordon, CEO of the American Health Information Management Association, will help with “knowing there are apples in the supermarket and if there are Granny Smith apples versus McIntosh apples.”
The more detailed codes can also improve patient health care in that they provide researchers with a clearer picture of patient needs, and which health problems may be increasing in certain communities. This data can help inform what health issues should, down the road, be researched and improved.
The adoption of ICD-10, while potentially confusing to medical billers at first, will tremendously improve patient experience in the long run. It will help advance medical research and analysis of public health issues. Better treatment options and more effective programs will evolve, and overall patient experience will drastically improve.