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ICD-10 Coding, is this a reality or a myth at present?

Posted Nov 11 2008 1:12pm

I am sure we are all in agreement that the new codes will allow for a better reporting system, but let’s first take a look at today and what is needed for a successful roll out, first off, money, something everyone seems to be running short of today. image

Second, is education, doctors, medical staff, etc. will need to be trained on how to use the new coding system.  Yes we have all seen the reports and information on the web, but that doesn’t make much difference until the actual day comes to where the codes are  implemented.  The system is using a new group of algorithms, in other words, formulas and to roll out a system that millions will be required to use without adequate training would be a shame. 

As technology evolves and formulas and data systems get more complicated, it is not as easy to roll out new programs as it has been in the past.  We are now all connected via the web and systems are far more integrated, where as in the past all one had to worry about was their own internal systems.  Why does this make such a difference?  In the past, if you made an error, it was corrected in house and everything was fine as the errors were caught before transmittal.  Today, much of what we do is in real time, so one mistake goes to perhaps over 20 different locations, so to correct an error, the other 20 locations need to have the correction as well.  Does this work all the time, no, as some systems still require someone to manually update and make the changes, some do it automatically, but we are all still in a transitioning stage, so there will be mistakes, data omissions, etc. until the day arrives where all data updates automate themselves.

Right now we have physicians who are working within a system to where much of the decision making processes have been removed from areas where they prevailed in the past, and still should, but that is not the case.  Just recently CMS was interrupted by a judge to stop the office from determining what benefits should be paid by Medicare, as they wanted to be able to make those decisions and allow only the “cheapest” treatment on the block for patients, thus limiting their access to many new cancer and other disease treatments, so in essence you can see the point here, how can a physician work within this system and prescribe the best care for the patient, and then be assured it is coded properly for payment.  Can we in fact be assured that assistance and software formulas will be in place to allow this to happen, and they change all the time too.   We get quarterly updates on the current ICD9 system right now.  Someone along the line has to enter a code to get the ball rolling for the rest of the process. 

From the Wall Street Journal:  Court Blocks White House Push on Medicare Expenses

Patients, doctors, treatment plans, billing, healthcare, coding, it all rolls in to one process so let’s hope there is enough money in the budget to cover and add a little extra if needed as technology will be there to throw out a left hook too in the process to complicate perhaps, but an awareness we should not lose track of.  There will be both implementation costs and education costs for the process to be a success so hopefully that will be taken in to consideration with planning.  We have watched the unfurling of the FDA this year with having to catch up on technology, and that they are doing and there has been a lot of criticism and rightly so in many areas, but we don’t want to see the same confusion and catching up when it comes to providing the point of care with patients and the physicians who take care of us.  It’s too late at this point to continue to rob Peter to take care of Paul and adequate funding and an education process will be needed to have this be a success without jeopardizing patient care.  “You give a man a fish you feed him for a day, teach him to fish and you feed him for life”.  BD 

The feds are eager for doctors, hospitals and insurers to start using a new set of billing codes called ICD-10. This version of the international system for classifying diseases has been kicking around for more than a decade, but the U.S. has stuck with ICD-9CM.

In the long run, the shift may be a good thing, because the new codes allow for more detail — and therefore better information gathering — about patients, their conditions and which treatments prove most effective.

The Centers for Medicare and Medicaid services, which is pushing for the new system to be in place within three years, estimates that adopting the new coding system could cost the medical system $1.64 billion over the course of 15 years.

http://blogs.wsj.com/health/2008/11/11/look-out-docs-here-comes-icd-10/

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