ICD-10 finally went live on October 1st, 2015. Hopefully, the years of delay has given providers, billing specialists and payers the time to train and prepare for the shift. If not, it will be a matter of learning as they go.
The History of the ICD Standard
The International Statistical Classification of Diseases and Related Health Problems (ICD) is the international standard for health management and clinical purposes. It is used to classify diseases, symptoms, abnormal findings, external causes of injury/illness, social situations, and other items that pertain to healthcare at the international, national, local, and patient levels. Countries can use the ICD codes as is, though many, including the U.S., choose to create their own version …show more content…
The intent of the ICD coding system was to classify diseases, diagnosis, and treatments for study and tracking purposes. It was never intended for medical billing. However, as the healthcare industry changed in the 1970s and 1980s, payers started using the ICD-9 for billing. This close integration between the ICD-9 codes and medical billing has made the ICD-10 implementation difficult.
The development of the ICD-10 began back in 1983. It was intended as a more detailed expansion of version 9. The standard was finished in 1992. Countries around the world began preparing to switch to version 10. Australia was the first in 1999. Canada did it in 2000. Countries around Europe, Asia, and Africa followed suit fairly soon after. The United States was notable the largest holdout.
U.S. government agencies started pushing for the ICD-10 adoption back in the 1990s. However, there was massive push-back from special interest groups, who made it a political struggle. It wasn't until 2008 that the Department of Health and Human Services proposed the government require the use of ICD-10 for tracking and billing purposes. In January 2009, they made a final rule that it would become the standard as of October 1, …show more content…
healthcare system. Here are just a few of them.
By the time the ICD-10 standards came out, ICD-9 had become an integral part of the U.S. healthcare billing system. Insurance companies and providers depended on those codes to complete the reimbursement cycle. Changing those standards meant updating the entire process. This caused a lot of resistance.
Another challenge the ICD-10 presented was its sheer size. ICD-10 involves 155,000 diagnostic codes and 85,000 procedural codes. This expansion is designed to gather more detailed information for both tracking and billing purposes. However, it is many times bigger than ICD-9. This caused insurance companies, providers, clearing houses, and other entities to balk at the idea of implementing version 10.
ICD-10 is not a mandate for private payers. Thus, an insurance company might choose to have providers submit ICD-9 codes for reimbursement, instead of version 10. This would require providers to maintain two different systems and to have medical information coded twice for a single patient visit, once for government reporting and once for billing.
The Impact of These
The History of the ICD Standard
The International Statistical Classification of Diseases and Related Health Problems (ICD) is the international standard for health management and clinical purposes. It is used to classify diseases, symptoms, abnormal findings, external causes of injury/illness, social situations, and other items that pertain to healthcare at the international, national, local, and patient levels. Countries can use the ICD codes as is, though many, including the U.S., choose to create their own version …show more content…
The intent of the ICD coding system was to classify diseases, diagnosis, and treatments for study and tracking purposes. It was never intended for medical billing. However, as the healthcare industry changed in the 1970s and 1980s, payers started using the ICD-9 for billing. This close integration between the ICD-9 codes and medical billing has made the ICD-10 implementation difficult.
The development of the ICD-10 began back in 1983. It was intended as a more detailed expansion of version 9. The standard was finished in 1992. Countries around the world began preparing to switch to version 10. Australia was the first in 1999. Canada did it in 2000. Countries around Europe, Asia, and Africa followed suit fairly soon after. The United States was notable the largest holdout.
U.S. government agencies started pushing for the ICD-10 adoption back in the 1990s. However, there was massive push-back from special interest groups, who made it a political struggle. It wasn't until 2008 that the Department of Health and Human Services proposed the government require the use of ICD-10 for tracking and billing purposes. In January 2009, they made a final rule that it would become the standard as of October 1, …show more content…
healthcare system. Here are just a few of them.
By the time the ICD-10 standards came out, ICD-9 had become an integral part of the U.S. healthcare billing system. Insurance companies and providers depended on those codes to complete the reimbursement cycle. Changing those standards meant updating the entire process. This caused a lot of resistance.
Another challenge the ICD-10 presented was its sheer size. ICD-10 involves 155,000 diagnostic codes and 85,000 procedural codes. This expansion is designed to gather more detailed information for both tracking and billing purposes. However, it is many times bigger than ICD-9. This caused insurance companies, providers, clearing houses, and other entities to balk at the idea of implementing version 10.
ICD-10 is not a mandate for private payers. Thus, an insurance company might choose to have providers submit ICD-9 codes for reimbursement, instead of version 10. This would require providers to maintain two different systems and to have medical information coded twice for a single patient visit, once for government reporting and once for billing.
The Impact of These