ICD-10 coming in October – how it will affect patients

What is ICD-10? ICD-10 (International Statistical Classification of Diseases) and relatedquick-icd-10-1-l-280x280 problems is the 10th edition of the medical classification of medical coding. These are developed by the World Health Organization (WHO) and will officially replace ICD9-CM coding system here in the United states October 1, 2015. ICD-10 will include up to 7 digit codes along with letters.  ICD-9-CM has been around since 1979 and ICD-10 will bring a refreshing, much needed ‘upgrade’ to the health care system of the future. (Other countries have already been using ICD-10 for a while now and are beginning to work on ICD-11).

We first must understand that ICD-9-CM (International Classification of Diseases, Clinical Modification) is the assigning of codes to every human being given a diagnosis, whether inpatient, outpatient, surgical or procedural, hospital or doctor’s office – any HIPAA compliant entity.  ICD-10 is a significant expansion of medical codes (155,000) than the 17,000 that ICD-9-CM had.

What does ICD-10 mean to me? If you or I went to the doctor and was given a diagnosis of allergic rhinitis for example, the code would be 477 (ICD-9 code).  This means that every medical professional across the United states and other parts of the world understand the same diagnosis code for allergic rhinitis of 477.  There are several lists for this code, in which ICD-10 has more specificity of what type of allergic rhinitis there is (J30.1 is the ICD-10 code) and more specific codes for the different types of allergic rhinitis. As more and more electronic medical records are put into practice in this country, the more these codes affect patient care. The true change that we as patients will really notice will come in the reimbursements and billing of our insurance, Medicare and Medicaid and all entities who are HIPAA compliant.  Insurance payers will need to watch out for double billing and double payments as there are very stiff penalties in place for this, including fraud.  So the next time you go to your physician’s office and you get that receipt, or once admitted to the hospital and upon discharge and your billing statement comes to you, be sure to go over it with a fine tooth comb – making sure you have not been double billed for services rendered.  That’s why it is also important to TRY and remain as healthy as possible, to diminish so much coding because there is a code for everything now!


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