By contrast, ICD-10 provides more specific data than ICD-9 and better reflects current medical practice. The added detail embedded within ICD-10 codes informs health care providers and health plans of patient incidence and history, which improves the efficiency of case management and care coordination functions. Accurate coding also reduces the volume of claims rejected due to indistinctness.
- ICD-10 improves operational processes across the health care industry by classifying detail within codes to accurately process payments and reimbursements.
- The transition also updates the terminology and disease classifications to be consistent with current clinical practice and medical and technological advances.
- Increased flexibility for future updates is indispensable and hence this is taken into account during the upgradation.
- Coding accuracy and specificity are enhanced to classify anatomic site, etiology, and severity.
ICD-10 makes sure that it supports refined reimbursement models to provide equitable payment for more complex conditions and thus streamline payment operations by allowing greater automation and fewer payer-physician inquiries, decreasing delays and inappropriate denials.
This provides opportunities to develop and implement new pricing and reimbursement structures including fee schedules, hospital and ancillary pricing scenarios based on greater diagnostic specificity.
Moreover, ICD-10 endows payers, program integrity contractors, and oversight agencies with opportunities for more effective detection and investigation of potential fraud or abuse and proof of intentional fraud. This new version promises more detailed data to better analyze disease patterns and track and respond to public health outbreaks.
We wish everyone a successful transition to ICD-10, if you need any assistance on coding please feel free to reach us at info@rapidcare.net
