Five Benefits of ICD-10

With just 20 months until the go-live date of Oct. 1, 2014, the International Classification of Diseases, 10th Edition diagnosis and procedure codes—better known as ICD-10—offers an updated medical coding system replacing ICD-9, now in use for more than 30 years.

Compliance with ICD-10 means that “everyone covered by the HIPAA is able to successfully conduct health care transactions using ICD-10 codes,” a statement from the Centers for Medicare & Medicaid Services Transition Basics.

ICD-10 directly impacts patient care and the practice of medicine. It is the way providers are paid and should be among the highest priorities. In fact, the transition to ICD-10 is critical to a successful launch of the healthcare transformation components of the Patient Protection and Affordable Care Act of 2010, and vital to transforming health and healthcare for the 21st century practice of medicine.

The following are five benefits of ICD-10, information of interest to physicians and their colleagues.
 
1. Patient experience: Patient care and experience will be enhanced, as healthcare costs begin to reduce, in the long-term, to more manageable levels. ICD-10 is expected to reduce provider overhead costs over the long term by minimizing the need for prior authorization episodes, which tend to delay patient course of treatment.

2. Health IT as foundation for healthcare transformation: ICD-10 will provide a 21st century standard coding system, a vital step to realize the full benefits of healthcare transformation in the U.S. This evolution to better care via ICD-10 includes: Meaningful Use of EHRs; interoperable exchange of health information; improving quality of care and clinical outcomes; improved secondary use of data for clinical research; vastly improved public health; and population health management.

3. Population health: The quality of population health and healthcare delivery will likely improve with a resolute definition of the current state of American’s health. A better understanding of population health would offer a more accurate picture of prevention and treatment needs, a positive impact on patient safety. In addition, staying ahead of disease progression can help determine the best course for evidence-based medicine.

4. Eliminating waste: ICD-10 will provide better clinical and business intelligence that will improve decision-making algorithms in patient care at the time of visit. It will better guide the development of preventive and self-care models, as well as needed education vehicles that will further improve consumer engagement, compliance and accountability. ICD-10 has the potential to reduce costs, or “waste,” by accurately pinpointing the severity of disease and helping create medically necessary plans of care and courses of treatment.

5. Cost savings: Using the correct medical code for the patient’s health status means information and billing, is of higher quality and accuracy.  
For more information on ICD-10 compliance, HIMSS offers several interactive and online resources, as noted below.

• ICD-10 PlayBook has background information, templates and step-by-step ICD-10 guidance for providers to meet the compliance deadline for ICD-10. Updated on a regular basis, the PlayBook contains materials contributed by more than 30 organizations.
• ICD-10 Provider Podcast Series includes podcasts on topics geared to providers transitioning to ICD-10.  
• HIMSS G7 Reports has analysis on ICD-10 implementation and compliance from provider, health plans, banks, government, consumer, employer and technology firms focused on healthcare transformation.

Juliet A. Santos, MSN, CCRN, FNP-BC, is senior director of business-centered systems, Medical Banking Project, for HIMSS.