ICD-10 in the News: Consumers Pay Attention

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December 2, 2015 by Mark Hammerstrom

For those in the medical profession, the term ‘ICD-10’ is all too familiar, and has been a long coming, arduous and costly initiative intended to expand (exponentially!) the number of diagnostic codes used to classify a patient’s condition and treatments.

United Credit Service has long been aware of the challenge migrating to this new system has placed on the resources of our medial clients and have been working to ensure we support these changes in our collection environment.

For the rest of us, however, the introduction of ICD-10 has passed with hardly a notice.  Really, it should not have.

That was why Christopher Snowbeck’s article in the November 25th edition of the Minneapolis Star Tribune “Doctors, hospitals now have expanded roster of codes to depict your maladies” jumped out at me.  This was the first time I had even seen even a passing reference to ICD-10, let alone a good summary of both the potential benefits and pitfalls of this massive change, reported in the general media.

For those of you not in the medical profession, ICD-10 is a federal government mandate to bring the United States into conformity with the 10th edition of the International Statistical Classification of Diseases and Related Health Problems.  Snowbeck points out that most of the industrialized countries in the world have already adopted ICD-10, with the US among the last to adopt the system.

That is a bit to digest, but as Snowbeck points out this is a really big deal for doctors and hospitals, and also consumers, because these are the codes used to track our health issues and treatments, and then submitted to insurers and used to determine how and what is paid for by whom.  Why this has been such a burden to prepare for, and will be more so to implement, is the sheer increase in the number of codes that will now be used.

Snowbeck writes “Whereas doctors in the past worked with about 14,000 diagnostic codes, the new system now offers roughly 70,000 codes for describing illness. The number of codes for documenting hospital procedures has grown from 4,000 to about 73,000 codes.”

You read that right.  Combining both codes used by doctors and hospitals, there are now more than 140,000 possible codes.

“This is the first Thanksgiving when doctors and hospitals are using a new and vastly expanded set of medical codes that include everything from W61.43XA for “pecked by turkey” to Z63.1 for “problems in relationship with in-laws” says Snowbeck.

Those endorsing the change point out that the old system originated in the 1970’s and while it has expanded with time, it has not kept pace with the need for greater specificity in diagnoses as our understanding of complex conditions has grown.

Given the greater capabilities we now have to process large amounts of data, more specific and detailed data could be analyzed faster and more accurately benefiting both an individual patient, as well as the population as a whole.   For example, the nature of a localized outbreak of a disease may be determined faster with better access to more accurate data.

Those not favoring the change point out the costs to do so are substantial.  “The American Medical Association argued that adopting the new codes would cost more than $225,000 for a small physician practice and up to $8 million for a large practice” says Snowbeck.  Like many electronic systems, doctors wind up moving through complex checklists and requirements rather than spending time working with the patient.

Of course, as consumers we need to be very mindful that these codes are ultimately used to bill us for medical services and monitor our bills accordingly for accuracy.

For our clients, of course, it means keeping a very sharp eye on the charges incurred by a debtor to ensure an account is being accurately billed before any collection activity ensues.  This can cause delays in turning over accounts that need immediate action, and impact revenue receipt.

Will ICD-10’s promise live up to its billing?  Time will tell.  Just know the next time your turkey pecks back there will be a code to track it!

Founded in 1950, United Credit Service, Inc. is a full service, licensed revenue cycle management and debt collection agency in Wisconsin providing effective, customized one on one management and recovery solutions for our business partners. Visit our website at http://www.unitedcreditservice.com, call 877-723-2902 or check out our YouTube video.

 

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