The US has been one of the first countries to adapt ICD 9 codes for medical billing and claims. With the industry focused on healthcare reform, changes in supporting functions are inevitable. The ICD 10 is far more comprehensive, featuring 68,000 documentation codes for diagnosis in comparison to the 14,000 of ICD 9. These codes could also include alpha numeric identifiers unlike ICD 9 and will span from 3-7 characters. Procedural codes for ICD 10 are expected to total about 87,000 and include 7 alphanumeric identifiers in comparison to 4,000 codes in ICD 9. The new codes are expected to be more compact in case classification, reducing chances of misrepresentation when dealing with insurance and medical billing companies.
Recently, Health Human Services (HHS) announced the finalization of the proposed one year delay in ICD 10 implementation which will buy providers and billers some time to regroup. The new rule would see the industry compliance date shifted to October 1st, 2014. The HHS recommends providers to plan ahead and train staff appropriately to function with the change. ICD 10 may require substantial restructuring, including transitioning to newer systems. This change will affect every physician operating within the country.
It should be noted that physicians are required to test their systems for compliance prior to the conversion date. This task would entail exchanging information internally and with external parties using the new ICD 10 codes. Practices using medical billing services will also need to ensure that their billers are conducting necessary external testing with payers and clearing houses. This exercise will help smoothen the transition, reducing unnecessary delays in reimbursements due to fundamental mistakes and oversights.
While ICD 10 would make identification much simpler and add more clarity, it is likely to increase the workload of billers and medical billing companies. With more characters and numbers, the process becomes much sophisticated and is likely to require more time. This may also mean more errors and possible denials during the initial implementation phase. However, the actual affect of ICD 10 on denial management is anyone’s guess.