Why the switch from ICD–9 codes to ICD–10 codes? While the health care industry has used ICD–9 codes for over 25 years, the code set has not been able to keep up with changes in medicine…newer conditions, and newer ways of treating patients.
The ICD–10 diagnosis code set has been designed to capture much more specific information on the patient’s diagnosis.
The procedure code set will enable hospitals to record much more specific information on procedures performed and devices used.
- ICD–10 CM provides tools to describe the condition of the patient in more detail.
- ICD-10 PCS provides better information on diagnoses and inpatient hospital procedures
- This data is routinely collected on claims
- The data can be used to improve many of the functions of the State Medicaid program
- ICD-10 CM and ICD-10 PCS will be the new data standard*
* ICD-10 is required for all HIPAA-covered entities for diagnosis coding, and for all inpatient healthcare providers for procedure coding. ICD-10 is a global standard, which will be implemented in the United States by October 1, 2014. ICD-10 establishes new standards of specificity for description of patient condition and care provided, while also introducing a new reimbursement paradigm to the over $3 trillion U.S. health care economy. While ICD-10 is a separate mandate, it enables more detailed analysis of healthcare outcomes are under The Patient Protection and Affordable Care Act, also known as “Obamacare.” It will set the standard for data stored in electronic medical records, part of the HITECH Act and Meaningful Use of Electronic Health Records stimulus funds under the American Recovery and Reinvestment Act (ARRA). In the future, data exchanged in health information exchanges (HIEs) will utilize ICD-10 codes.
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