Healthcare Technology Featured Article

August 19, 2013

HIMSS Playbook Offers HRAA White Paper to Improve ICD-10 Transition

Health Revenue Assurance Holdings, which operates under the ticker symbol "HRAA," has announced that its whitepaper on dual coding has been added to the Health Information and Management Systems Society's (HIMSS) ICD-10 Playbook.

ICD-10 is a medical coding system developed by the World Health Organization (WHO) to replace ICD-9, the coding system it released in the 1970s. Many countries have implemented ICD-10 already, but the U.S. won't fully transition to the new system until Oct. 1, 2014.

ICD-10 has many more codes than ICD-9: a whopping 69,000 versus ICD-9's 13,600. However, most of the changes are lateral. Instead of having a single code for an ovary condition, ICD-10 has individual codes for bilateral, left side, right side and unspecified conditions.

Codes will also be expanded to report current manifestations of a particular disorder. For example, if a patient with Type 2 diabetes develops diabetic retinopathy, then one code will report "Type 2 diabetes with diabetic retinopathy."

The biggest problem with ICD-9, according to the American Academy of Professional Coders (AAPC), is that it's simply out of room. Medical science is discovering new conditions all of the time, and ICD-9 has run out of codes for newly discovered disorders.

ICD-10 will also allow better population-wide tracking of diseases and effective outcomes. ICD-10 will also provide more information to payers so that initial claim submissions are easier to understand.

HRAA works to help health systems, hospitals and medical practices make the ICD-10 transition by starting to dual code. For the first two years after October 2014, systems will have to be capable of accessing both ICD-9 and ICD-10 codes. Also, mapping will be required to find equivalent codes to enable disease tracking, outcomes studies and medically necessary edits.

HRAA recommends that hospitals start using dual coding now so that medical coding specialists can avoid creating financial risks for payers. Hospitals also need to talk to their software vendors about dual storage of ICD-10 and ICD-9 data.

Edited by Alisen Downey

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