How does rewriting the health care code help you?

New changes to the healthcare code may not affect your next visit to your healthcare provider, but they may make it easier for you to review your insurance claims, compare health costs and find the best possible care.

They may also make it easier for your healthcare provider to understand your history and the diagnosis and procedures that you have had previously.

The International Classification of Diseases and Related Health Problems – 10th edition, known as ICD-10, is a more specific and descriptive code that is planned to replace the current code, ICD-9, on October 1, 2014.

While this may seem like just another governmental update, it relates directly to diagnosis and health insurance claim reimbursement.

ICD-10 will provide healthcare providers with a tool to track detailed diagnosis that identifies: the disease or injury, which part of the body was affected, which side of the body was affected, the severity of the disease or injury, and the frequency of a patient’s visit for a specific health issue.

According to the American Medical Association, the ICD-10 codes sets are very different from the ICD-9 code sets.

ICD-10 adds specificity to diagnosis and procedural information that results in better historical data regarding patient diagnosis and treatment. Just a few of the differences of the ICD-10 code system include: increased character length, an increased number of codes available for use, and the use of full code titles. Below is a chart from the American Medical Association that makes a head-to-head comparison of the diagnosis codes.

Comparison of the diagnosis code sets

ICD-9 ICD-10
3-5 characters in length 3-7 characters in length
Approximately 13,000 codes Approximately 68,000 available codes
First digit may be alpha (E or V) or numeric; digits 2-5 are numeric Digit 1 is alpha; digits 2 and 3 are numeric; digits 4-7 are alpha or numeric
Limited space for adding new codes Flexible for adding new codes
Lacks detail Very specific
Lacks Laterality Has laterality

According to the American Medical Association, the new code sets provide greater detail to describe precisely what medical procedure was done to the patient. There is also the ability to add new procedures. The code set is designed so that each code character has the same meaning within the procedure section and across the code set where it is possible.

For instance, under the old code, if you were treated for a broken wrist, the code used to describe your injury would be the same whether you broke your right or left wrist. With the new coding, providers are able to enter codes that detail which wrist was broken, how severe the break was, and how many times you visited your physician for treatment of that particular break.

The specific codes used in ICD-10 will help improve patient health by providing data that can be studied to:

  • improve patient care by documenting which procedures resulted in the best outcomes
  • identify chronic diseases earlier in the progression of the disease
  • track public health including outbreaks of communicable diseases
  • identify new diseases
  • analyze accidents and injuries
  • track the side effects of drugs to improve patient care and safety

ICD-10 also will enhance the healthcare community’s ability to track outbreaks of the flu or other communicable diseases, as well as identify new diseases and the best treatments for those diseases.

In addition to allowing patients to be appropriately reimbursed for the care provided, ICD-10 may help reduce coding errors and prevent fraud, which may help lower healthcare costs.


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