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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