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ICD-10 is Coming. Will Your Medical Billing Department Be Ready?

Health Insurance Companies Process 1 in 5 Claims Wrong

Number of Diganosis Codes to Skyrocket from 14,000 to over 69,000 under ICD-10

What is ICD-10?The new ICD-10 diagnosis codes take effect on October 1, 2015, and all healthcare providers are required to comply with the new regulations or they may have trouble with insurance reimbursement. These changes in the medical billing practices are significant enough to have caused marked slowdowns in billing and payment in other countries.

So what can a healthcare provider expect when their office phases out ICD-9 and incorporates the ICD-10 billing requirements into their healthcare practice? First, there is an increase in the number of billing codes, from 14,000 to 69,000.

Coders will need to have a more detailed knowledge of anatomy and physiology, as well as medical terminology. Coders will also have to work more closely with doctors and educate them on proper coding methods. Superbills, that had been used in the past as a way of quickly coding diagnoses and services, may no longer be effective timesavers.

Unfortunately, more codes to choose from may render superbills obsolete. Physicians will also have to invest in new software designed to accept the longer digit codes.

The new ICD-10 codes also mean changes in patient coverage. Doctors will need to be more specific in their documentation and code observations such as stages of healing. The new ICD-10 codes include more payment limitations for services. Case managers’ phone call volume will increase as they deal with an increased need for patient education on coverage charges.

Medical providers can expect a slow down in accounts receivable which decreases cash flow. Medical billing departments can expect an increase in call volume for confusing or rejected claims; the number of billing audits may also increase.

Other countries that have already implemented the ICD-10 codes report a 50% longer turnaround time for medical accounts receivable and a decrease of 50% in coder productivity.

If the changes are implemented over time and proper education given, these changes hopefully will have only a short-term and minimal effect on the financial health of the healthcare provider.

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is a 20 year veteran of healthcare having managed medical practices. He advises medical practices, physicians and practice administrators on how to run their practice and manage their medical billing and revenue cycle management. Manny speaks, blogs and makes videos at www.CaptureBilling.com, a blog that is tops in the medical billing and coding field. READ MORE

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9 Responses to ICD-10 is Coming. Will Your Medical Billing Department Be Ready?

  1. Not relevant to this. But could you please help me by telling those countries name who are working on icd 10?..is new zealand is one of them?

    • There are several countries that use ICD-10 for coding. Some of those are:

      Australia
      Brazil
      Canada
      France
      Germany
      Korea
      Netherlands
      Denmark
      Finland
      Iceland
      Norway
      South Africa
      Sweden
      Sweden
      Thailand

      American Society of Clinical Oncology (ASCO) states that “overall, a total of 138 countries have adopted ICD-10 for mortality data purposes, and 99 countries have adopted it for morbidity. The United States has also already implemented a portion of ICD-10 for mortality data, effective January 1, 1999, but we are still waiting to convert morbidity, diagnosis, and procedure coding over to the new ICD-10-CM system.”

  2. Need information on Psychiatric billing. Where is seminar? How Much and times? Can you do on internet? Book to purchase?

  3. […] September 7, 2011. Ms. Jennings will be discussing the importance of medical terminology for the ICD-10; scheduled to be released in […]

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The analysis of any medical billing or coding question is dependent on numerous specific facts -- including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies (as well as coding itself) are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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