Coding professionals have the training and experience to limit the learning curve involved in transitioning to the new system, and HIM professionals are certainly ready to take the lead in retraining and education for new and experienced users of health data. Let us begin planning for ICDCM and enjoy the benefits of this greatly improved classification system.
Federal Register 63, no. Available at www. Federal Register 65, no. May 29, Testimony by Dr. The current ICDCM diagnosis codes do not provide sufficient clinical specificity to describe the severity or complexity of the various disease conditions. In particular, the codes for healthcare encounters for other than disease V codes do not provide enough specificity. Consequently, there are increasing requirements for submission of additional documentation in order to support claims. The exchange of meaningful healthcare data with healthcare organizations and professionals around the world is hindered by the fact that many countries are presently using ICD or a clinical modification of it Australia and Canada, for example, have modifications.
Even in the US, mortality statistics information on death certificates have been collected using ICD since The current ICDCM system is ineffective for effectively monitoring utilization of resources, measuring performance, and analyzing healthcare costs and outcomes.
There are many uses of coded data, including: Designing payment reimbursement systems with emphasis on the processing of claims specifically for reimbursement, Measuring the safety, quality, and efficacy of medical care, Designing delivery systems and setting healthcare policy, Monitoring the utilization of resources while improving financial, clinical, and administrative performance, Providing healthcare consumers with data regarding the cost and outcome s of various treatment options, Identifying, tracking, and managing public health risks and disease processes, Recognizing and identifying abusive or fraudulent reimbursement practices and trends, and Conducting healthcare research and clinical trials and participating in epidemiological studies.
ICDCM offers the addition of information relative to ambulatory and managed care encounters. In ICDCM, some three-character categories are not used in order to allow for revisions and future expansion. Instead of grouping by categories of injury or type of wound, ICDCM groups injuries by site of the injury and then the type.
Excludes notes were expanded in order to provide guidance on the hierarchy of the chapters and to clarify priority of code assignment. Some conditions with a new treatment protocol or perhaps a recently discovered or new etiology have been listed in a more appropriate chapter. Combination codes are used for both symptom and diagnosis, and etiology and manifestations-for example K Codes for postoperative complications have been expanded. Also a distinction has been made between intraoperative complications and post-procedural disorders-for example, K91 Intraoperative and postprocedural complications and disorders of digestive system, NEC.
This may have been accomplished by means of movement from one chapter to another or one section to another. More complete descriptions-In ICDCM, the subcategory titles are usually complete so that the coder does not have to read previous codes to understand the meaning of the code. Fifth and sixth characters-Fifth and sixth characters are incorporated into the code listing rather than having common fifth digits listed at the beginning of a chapter, section, or category.
Laterality-ICDCM incorporates laterality of conditions or injuries at the fifth or sixth character level. These extensions are most often found in the injury codes but are found in other chapters. Terminology used-Many of the category code or subcategory code titles have been changed to reflect new technology and more recent medical terminology.
Postprocedural conditions-There are many more codes added to ICDCM to describe postoperative or postprocedural conditions. Trimester specificity-ICDCM codes in the pregnancy, delivery, and puerperium chapter includes codes designating the trimester in which the condition occurs.
Consider submitting paper claims, if the Administrative Simplification Compliance Act waiver provisions are met. If you take this route, be sure to allot time for you or your staff to prepare and complete training on free billing software or portals before the compliance date.
Each of these options requires that the provider be able to code in ICD Medicare claims will not be audited based on the specificity of the diagnosis codes used as long as they are from an appropriate family of codes. Where can I find a list of ICD codes? National Center for Health Statistics. Section Navigation. Facebook Twitter LinkedIn Syndicate. Minus Related Pages. On This Page.
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