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The Pros And Cons Of ICD-9

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We all know that on October 1, 2015 ICD-9 will no longer be precise information in the coding world. It will soon be ICD-10. Which is considered a major long overdue upgrade. It will advance healthcare in many many ways.
Everyone is probably wondering why is ICD-10-CM and ICD-10-PCS are better alternatives? Well, ICD-10 contains the most remarkable changes in the history of ICD. Its alphanumeric format provides a better structure than ICD-9, allowing considerable space for future revision without disruption of the numbering system, much more than is possible with ICD-9-CM. Replacing ICD-9 with ICD-10 it will provide higher standard information for measuring healthcare service quality, safety, and efficacy. Doing so it will provide better data for quality measurement, and medical error reduction, outcomes measurement, clinical research, clinical, financial, and administrative performance measurement, health policy planning, operational and strategic planning and health-care delivery systems design, payment systems design and claims processing, reporting on use and effects of new medical technology, provider profiling, refinements to current reimbursement systems, such as severity-adjusted DRG system, pay for performance programs, public health and bioterrorism monitoring, …show more content…

Fewer rejected claims ICD-10 is more detailed and organized than ICD-9. Better claims and faster approvals reduced claims cycle will lower administrative costs for physicians. For surgeons the new and cutting edge procedures. The surgical code will be built on the type of surgery, body system, root operation, body part, approach, device and qualifiers. The ICD-10 codes accurately reflect the goal, the location, the steps of the procedure and no restrictions of procedural naming conventions and agreed upon methodology. Payers will cover more procedures, reject less, pay faster, and reimburse more

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This would result in more queries for clinicians which adds up to the time medical coders and clinicians will be unable to prepare ICD-9 claims. Ironically, this comes at a time when practices are being encouraged to make their business practices increasingly efficient and save cash to get through periods of delayed reimbursements after October 1. However, there is a solution of hiring more coders as employees or freelancers to cover the deficit. But this comes at the cost of more planning and budgeting for staffing.

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NCCI is the National Correct Coding Initiative. It 's important There are two categories of edits: Physician Edits: these code pair edits apply to physicians, non-physician practitioners, and Ambulatory Surgery Centers Hospital Outpatient Prospective Payment System Edits (Outpatient Edits): these edits apply to the following types of bills: Hospitals (12X and 13X), Skilled Nursing Facilities (22X and 23X), Home Health Agencies Part B (34X), Outpatient Physical Therapy and Speech Language Pathology Providers (74X), and Comprehensive Outpatient Rehabilitation Facilities (75X). Both the physician and outpatient edits can be split into two further code pair categories: Column1/Column2 Code Pairs: these code pairs were created to identify unbundled services.

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For example ICD-10 has expanded diagnoses codes from around 14,300 to around 69,000) and so the suggested need for a greater understanding of the logic and relationship affect between ICD-10 codes and current ICD-9-CM contracts and reimbursements means significant change to the status quo. In my experience is that change is feared or at least distrusted. So as I read the article the need for training to both reassure and build confidence seemed the key point. I think if providers can show staff system wide how use of ICD-10 codes will benefit the system and patient care, if the providers can fully integrate ICD-10 codes into the fabric of the organization then in time ICD-10 will become the familiar model to all (including insurers), just another part of daily work probably leading to that same mix of ambivalence. I think the trick is to do exactly what Padarthy suggests, to proactively and methodically integrate ICD-10 across the whole system in a measured and methodical way with due care to the impact on

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Marsha McMillen Unit 5 Math Discussion After researching the metric system uses in the medical field, I found quite a few uses just used in the billing and coding field. It is used for cost, production to reduce supply and labor costs, clinical performance, such as quality of patient care, also called “patient outcome” data. Other uses are, Patient Safety, nearly 100,000 Americans die each year, because of medical mistakes, that happened during their stay at the hospital, these accidents can lead to longer recoveries and permanent disabilities. We use metrics in-patient surveys after treatment/release, to measure patient satisfaction of their care.

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Impact of CMS Regulations and Reimbursement Models The Health Care Industry HCM307-1802B-03 Unit 1- Individual Project 1 Michael Green May 22, 2018 Introduction Healing Hands Hospital is preparing financially for the many different reimbursement changes associated with Medicare Advantage Plans. My financial team and I, have been asked to evaluate our current billing and operations workflow processes and incorporate the current trends. We will be discussing how Medicare Advantage affects Healing Hands Hospital, and how we can utilize these trends to maximize patient care. Organizational Budget Reimbursement and financial trends will change go hand and hand.

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The ICD-10 switch went live on October 1st and we are now left assessing which predictions were on the money, which missed the mark, and which effects are currently impacting the system the most. Before the compliance deadline, many compared ICD-10 to Y2K and HIPAA 5010 that came before it. Many possessed an almost apocalyptic mentality and expected the worst. Presently, however, it appears as if ICD-10 has been similar to Y2K only in the sense that their courses of action have run in a similar fashion: both have passed with a few hiccups along the way, but relatively smoothly and insipidly.

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As a former student in M201/ M202, I have to admit that I was a bit intimidated at the size of the ICD-10 CM/PCS coding books. However, as we began learning about the guidelines and rules to coding it all started to come together. Last year’s transition to ICD-10 for the United States, had required changes for all health care systems.

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How many times have your ICD-10 leadership team asked themselves the question, are we ready for the conversion? The clock is ticking and there’s very little time left for the healthcare organizations that are behind schedule. On October 1, 2015 the healthcare industry will begin to use, process, and exchange ICD-10. Providers and practices should be preparing themselves for the transition and approaching the implementation with confidence.

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ICD-10 helps gather and sort vast amounts of patient data. No way does it increase the quality of care provided. That will be done by advances in medical science. The ICD-10 codes will be entered once there is a diagnosis and the treatment will be the same. ICD-10 is not going to change how our healthcare system functions, it is just going to simplify data handling and facilitate better payments, which will be a win-win situation for everyone involved.

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Meaning they would identify right VS. Left. The CM in ICD-9 means clinical modification, and the PCS in ICD-10 mean Procedure classification system. After graduation

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The current ICD-9 has been used since 1979. Changes to these codes will

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The physician also risks not getting paid by the insurance company if they do not administer the less expensive treatment. This conflict could also be

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The ICD is a valuable tool for both healthcare providers and researchers as it can improve patient care and advance our understanding of the disease.

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How will they pay for medical ex-penses, doctors’ visits, hospital stays, and prescriptions? “With the average hospital stay

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