Your financial success depends on being ready for ICD-10. The adoption of ICD-10 goes into effect October 1, 2014. Although preparing for the transition is mandatory, it will not be a simple task. ICD-10 will multiply and alter the codes vs. providers and payers use. The number of available codes will expand from 24,000 to 155,000. The transition was necessary because of two main reasons:
Using ICD-9-CM was difficult to evaluate the outcome of new procedures and emerging health care conditions when there are not precise codes. Most importantly, there is a mission to improve the ability to measure health care services provided to patients, enhance clinical decision-making, track public health issues, conduct medical research, identify fraud and abuse and design payment systems to ensure services are appropriately paid.
Payers cannot pay claims fairly using ICD-9-CM since the classification system does not accurately reflect current technology and medical treatment. Significantly different procedures are assigned to a single ICD-9-CM procedure code. Limitations in the coding system translate directly into limitations in the diagnosis-related groups (DRG).
According to the NCHICA, with the adoption of ICD-10-CM (diagnosis codes), stakeholders will have the chance to realize increased specificity in clinical information that can lead to more accurate and timely reimbursements, better quality of patient care and improved disease and care management. ICD-10-CM incorporates much greater clinical detail than ICD-9-CM. The terminology and disease classification have been updated to be consistent with current clinical practices. The ICD-10 classification system will provide much better data needed for:
? Measuring the quality, safety and efficacy of care
? Reducing the need for attachments to explain a patient’s condition
? Designing payment systems and processing claims for reimbursement
? Conducting research, epidemiological studies, and clinical trials
? Setting health policy
? Performing operational and strategic planning
? Designing health care delivery systems
? Monitoring resource utilization
? Improving clinical, financial and administrative performance
? Preventing and detecting health care fraud and abuse
? Tracking public health and risks
MB4Y will work with you to test ICD-10 ready products. We will take a proactive role in assisting you through the transition so claims are paid. Codes & services will be obsolete if step are not taken to prepare. ICD-10 investment will allow your organization to move beyond compliance to achieve competitive advantage. Don’t delay, MB4Y is your prescription to success.