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ICD-10 and Medical Billing

Mar 16, 2019
October 1, 2015 was the deadline for all medical facilities to officially switch medical coding and billing to the ICD-10 format. ICD-9 coding had been used since the 1970s, with periodic updates and expansions to the coding used. In 1999, ICD-10 was published and many developed nations of the world began to adopt the format. The United States was not on board at first and has repeatedly delayed upgrading to the new coding system.

Why Delay the Upgrade?

Changing the formatting of all medical coding is hugely expensive and time-consuming. For some small practices that have been doing medical billing manually, the change may be very difficult to implement. Training everyone on staff and changing the way that medical billing is done to suit the new system may hamper productivity and the ability of the practice to deliver quality care to patients. In addition to these woes, some practices could not survive the delays in payment resulting from billing errors during the adjustment phase.

Why Implement the Switch?

While making the switch has not been easy, it is worth it in the end. Using ICD-10 codes finally brings the United States into the loop with countries that have been using the coding system for years, fostering better communications between countries. The coding system is also more accurate. There is about 10 times the number of codes in the ICD-10 system as in the ICD-9 system.

Benefits of Larger Code Sets

In the years since ICD-9 was introduced, huge amounts of advancements have been made. New procedures, surgeries, and tests have been introduced. New diseases have been discovered. The limited ICD-9 set of codes made it difficult to code for many of the newer procedures and disease classifications. ICD-10 has much more versatility and was designed in such a way that it will be easy to add new codes as advancements in medicine are made.

Benefits of More Accurate Coding

The goal of medical billing should always be to bill as accurately as possible. Billing more accurately will allow insurance companies to more accurately estimate payouts, which may help to streamline claims payments. Having a more accurate medical coding system will also allow researchers to use the codes to identify patterns in medical diagnoses and treatments. This may help to improve the quality of the information available to the public and may even assist with finding better treatments for diseases.

Making the Switch

Making the switch to ICD-10 has been hard on some practices. In some cases, it may be easier for the office to switch to outsourced medical billing. Having qualified experts handle the medical billing can help to ensure a higher percentage of accepted claims and can take the pressure off of the office staff. Billing software that simplifies the new coding system and provides assistance with determining the right coding for different diseases and procedures may be the best way to go for other offices.