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What’s ICD-10 and why does it matter?

Or, the better question to ask is, do you ever go to the doctor?  If the answer is yes, then ICD-10 will have an impact on you.  More importantly, it has an impact on the entire healthcare system and the schools preparing individuals to enter the field of medical billing and coding.

ICD stands for International Classification of Disease and is the U.S. health system’s list of up to seven-character alphanumeric codes to describe diagnoses. Standardizing codes improves consistency among physicians in recording patient diseases and disorders for the purposes of payer claims reimbursement and clinical research.  There are different codes for hospitals versus physician offices.  The current code group in place is ICD-9.  However, ICD-10 has been a discussion for years and will officially become standard as of October 1, 2015.  Simply put, the United States government has updated the classification from ICD-9 to ICD-10.

According to the CMS (Centers for Medicare and Medicaid Services), the change from ICD-9 to ICD-10 is “More than an update, (it’s) a leap in how we define care.”

Why ICD-10 for Medical Billing & Coding?

The new coding system in the United States was developed by a group of physicians, under the sponsorship of the World Health Organization, who felt that a thirty year old coding system didn’t provide the needed detail in patient care.  Better data allows for better analysis and improvement in quality care.

The detail of ICD-10 is far more in-depth, enhancing the complexity of coding for patient care.  For a particular injury or treatment, with ICD-9 there may be 14,000 codes to choose from for coding.  With ICD-10, there may be 69,000 codes to better capture specificity of care.

The changes in the industry are in need of more qualified coders, with an in-depth knowledge of ICD-10 and advanced coding.  There are different codes used in a physician’s office than in a hospital where advanced coding is utilized.  Educational curriculums preparing graduates for this evolving and highly complex field will need to provide ICD-10 preparation and advanced coding, including coursework on insurance reimbursements and hospital coding.

When does ICD-10 become effective?

ICD-10 becomes effective on October 1, 2015.  Everyone will be impacted, whether you work in healthcare or are receiving treatment as a patient.  The change is dramatic and a tremendous undertaking, so the transition may be rocky at times.  From an educational standpoint, colleges should have already been addressing their curriculums to meet these industry updates.

I can’t write this blog as the Dean of Allied Health at the Florence, KY campus for Beckfield College and not tell you how we have handled things.  We have incorporated ICD-10 into our curriculum and have had training on it for our students for the last year and a half.  Advanced coding has been a part of our curriculum in our associate degree program for quite some time, at both campuses – Florence and Cincinnati, OH.  The government may have been slow to confirm the when, but the reality of it coming was not in question.  We want our students prepared for the field.  That’s the mission of a higher education institution – prepare graduates for the real work with the skills needed.

Here’s to better data being compiled by coders everywhere!

Want to learn more? Check out the links below! 

Medical Billing & Coding Program

Medical Billing & Coding FAQ

Dolores Dominguez, CPC, RMA, BS, ABM

Dean of Allied Health
Florence, KY Campus
Beckfield College

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