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Sample Essay on ICD-10 and How It Affects Hospitals

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Sample Essay on ICD-10 and How It Affects Hospitals

The International Classification of Diseases (ICD) is a code set published by the World Health Organization meant for defining diseases, symptoms, abnormal results, complaints and external causes of disease or injury. The ICD-10 is a copyright of Health World Organization and authorizes adaptation of this type of code system for the management purposes. It is agreed that every modification towards the ICD-10 should match WHO conferences for this code set. ICD-10 is an updated international version code set used to report mortality rate. Some countries started to adopt this technique since 1994, but later became partially implemented in America in 1999 to monitor mortality reporting. ICD-10 is a clinical adjustment aimed to classify morbidity treatment and replaced ICD-9 coding. It was prepared following a detailed assessment by scientific advisory team and broad consultation with doctors and medical coders to facilitate medical accuracy and effectiveness (Robert, 2003).

In comparison with ICD-9, ICD-10 offers more definite data and enhanced results in the current clinical practices. The additional detail incorporated in ICD-10 codes notifies health care givers and clinical plans of a patient history and incidence that improves the usefulness of care coordination and case management functions. In addition, accurate coding reduces the level of claims decline due to indistinctness. It is evident that the changeover to ICD-10 characterizes a considerable impact to providers especially in view of other numerous initiatives associated to value based purchasing, Accountable Care, improved audits and multiple other programs that can turn into a governmental burden. Therefore, ICD-10 embodies a reinforcement to every of this initiative since it represents definition of patient health complications as well as institutional procedures carried out to maintain or improve those complications. Without the precision and clarity provided by this type of code set, most of these initiatives may not effectively achieve the objective of health care delivery improvement (Robert, 2003).

ICD-10 involves a large number of codes that facilitates much bigger level of specificity in coded patient data. It offers an improved way of indentifying risk associated to patient wellbeing by supporting more precise definition regarding the cause of a patient’s condition as well as the level at which care delivery has relieved or impacted patient experience and outcome. This technology has also improved health care quality because clinical care is only significant if the data employed to define services and conditions perfectly represent the realty of health care (Gallagher, 2013).

One of the challenges faced by the transition is as a result of code disconnection between ICD-9 and ICD-10 whereby the existing clinical knowledge would be diminished considerably for a period of time. Despite the fact that crosswalks are being or have been attempted between the proposed and current code sets, until now, they cannot deal with all of the similar issues, hence do not resolve the issue of data stability. Since diagnosis and procedure code sets keep on changing, these alterations are insignificant in nature to contain new clinical conditions or healing procedures. However, ICD-10 is a huge renovate of coding system, which requires field size development and complete explanation of code set values. The challenge that may be faced by payers is that moving to ICD-10 requires critical training to have a successful transition, but there is slight agreement about the training required and who needs to be coached. Coders require carrying out a significant training for the physicians, support staff and payers on the new coding system, which is somehow expensive (Gallagher, 2013).

 

Since the implementation of ICD-10, many hospitals are engaging in an important planning to make their billing systems upgrades or modifications. They are organizing plans to test ICD-10 with doctors and other providers of health care. This is aimed to carry out acknowledgement testing that is limited and just check to find out if claim with  the ICD-10 codes will succeed in their medical services. Health care providers are also planning to carry out end-to-end testing that test the claims from compliance through to the delivery of transmittal advice. This test is meant to provide much detailed information for doctors and other medical care providers regarding how their claim will be processed and compensated by ICD-10 codes.

SNOMED is a terminology standing for input systems that codify the health care information obtained in an electronic health record throughout the patient care period. This system is designed to be used electronically rather than paper-based medical record systems (Warren & Hartley, 2012). The significance of using reference terminologies is to enhance exponentially with the aim of producing information required for statistical study, reimbursement as well as other minor uses. Industry professions state that there is no obvious relationship between SNOMED and ICD-10; however, the prospective for the two to work jointly to impact delivery health care is high. This is why various experts propose that medical care organizations influence the ICD-10 transition procedures as a chance to establish SNOMED within their electronic health record to place the most effective establishment for future health care delivery. Therefore, establishing an extensive medical terminology basis of SNOMED alongside an enhanced detail of ICD-10 code system provides a high quality approach towards addressing impending compliance deadlines (Bowman, 2003).

 

References

Bowman, S. (2003). Coordinating SNOMED-CT and ICD-10: Getting the Most out of Electronic Health Record Systems. 

Gallagher, J. (2013).The transition to ICD-10 a mighty challenge for healthcare providers. 

Robert, E. (2003). Replacing ICD-9 with ICD-10 and ICD-10 challenges, estimated Costs and potential benefits.

Warren, J., Hartley, A. (2012). Standardized Terminologies used in the Learning Health System.

 

 

 

 

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