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10 Ways ICD-10 Will Improve Quality of Care
2. Improves public health tracking
ICD-10 improves the ability of public health officials to track diseases and threats, dangerous settings and even acts of bioterrorism that might otherwise go unrecognized.
It "is more specific and fully captures more of the public health diseases examined than ICD-9," says a paper by Valerie J.M. Watzlaf, [PDF] professor of health information and management at the University of Pittsburgh. Information was better for capturing reportable diseases, the top 10 causes of death, and illnesses related to terrorism.
For example, ICD-9 has no way of classifying certain serious foodborne illnesses, such a clostridium perfringens, but ICD-10 does. And ICD-10 is much more specific about syphilis, HIV and pneumococcal infections.
3. Discourages upcoding, fraud
One potential for ICD-10 is that with more specificity, it will be a lot tougher for hospital coders to lump patients into a more severe disease or procedure category. Bowman says, "In an ICD-9 world, codes are more ambiguous," says Bowman.
"It will be harder for people to, when they encounter something that seems initially like it's on the border of one code or another, to say, 'I think I can get this into this (higher paying) code.' We'll be seeing a lot less of that with ICD-10."
For example, ICD-10 features a way of identifying each side of the body. Bowman says that if a patient seems to be having numerous procedures on the same foot, either the treatment "isn't effective" or it may be a billing misadventure, she says. "It helps with fraud, because payers can check for multiple encounters/treatment for the same anatomical site."
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Comments are moderated. Please be patient.
ralph (2/17/2012 at 12:48 PM)
I'm trying to understand how going from 14,000 CPT billing codes to 140,000 ICD-10 billing codes improves quality of medicine? It might improve the quality of live of bean counters who have to sort through this mess, but thats it. Thats why at www.medibid.com there are no billing codes, and patients save about 80% off of the billed rates
patient advocate (12/2/2011 at 2:30 PM)
Physician practices are provided with a substantial amount of money to ease the burden of modernizing their practice to use EHRs, and transitioning to ICD10 is certainly part of that. A $40,000+ investment by American tax payers that is available to all physicians that adopt new HIT technologies is a far cry from "and do it all at my own costs".
Dr. Nathan (12/2/2011 at 11:01 AM)
The transition to ICD-10 in other countries will not parallel the experience of the U.S. The main difference is that other countries adopted versions of ICD-10 that had much fewer codes. Physicians in the U.S. are required to fund a transition that will be far more complex and difficult than in any other country due to our multipayer health care system. In addition, other countries offered government funding to offset implementation costs. Other countries also eased their health care systems through the transition by implementing ICD-10 in phases or in specific settings. It seems the only ones who are optimistic about ICD-10 are the hospitals and their consultants who are dreaming up expanded billing schemes. Physicians shouldn't be expected to carry a disproportionate burden of the ICD-10 investment costs when others will be the primary financial beneficiaries.