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The Home Care Association of Florida
www.homecarefla.org
FEATURE
Providers can expect to see more accurate
reimbursements! The vagueness and
ambiguity of the ICD-9 code set has
definitely resulted in some difficulties
with claim creation. The ICD-10 system
is built on a platform and logic that is
better suited to create an effective payment
system. Delivering more specificity in the
code sets may result in better justification
of medical necessity. In the ICD-9 code
set some conditions that support medical
necessity are classified with the same codes
as those that do not, creating inefficiency
and difficulty for the provider and the
patient. With the greater detail of the
ICD-10 code set, these conditions will be
classified appropriately to support medical
necessity and allow providers and patients
to provide and receive appropriate care.
Additionally, the detail of the ICD-10 code
set may be able to identify more unique
medical services that use new technology
so that providers can bill for them more
accurately. While at first, it may seem like a
lot of work to learn the new code set, once
it is implemented, it is expected that the use
of ICD-10 will result in less coding errors
because the set is less ambiguous, more
detailed, and better organized than previous
code sets. Once we are all under way using
ICD-10 we can expect to see more detailed
reimbursements and less coding errors.
ICD-10 is a claims-friendly code set!
The greater detail of ICD-10 will also
enable the healthcare community to deliver
better patient care, which is ultimately the
primary goal of our community. With
a greater capacity for data analytics, the
industry will be able to measure the
quality of healthcare delivered more
effectively. The enhanced analytics will
enable agencies to create better policies,
standards, procedures, and structures.
Our community, working as a fluid and
cohesive unit, will ensure that patients can
expect and receive improved care.
The ICD-10 code set will help the research
community, where data truly is king. The
increased amount of actionable data
provided by ICD-10 will enable researchers
to find better correlations between medical
conditions and their causes, treatments,
and end results: researchers will be able to
create better, more effective treatments.
The United States will be joining other
nations in adopting the ICD-10 code set.
This will provide for improved healthcare
analytics at a global level. Our community’s
resources will now have meaningful
data to expand so that we can join the
global healthcare community and take
advantage of the available information
by investigating universal healthcare data.
Increasing the data pool will enable our
healthcare system to stay informed and
aware of major healthcare trends and
provide our healthcare system a definitive
boost in intelligence far beyond our nation’s
geographic boundaries
While the change to ICD-10 will be a lot
of work, we will all see the benefits of
adopting a more current, comprehensive,
and functional code set. Improving
the intelligence of providers, payers,
researchers, IT vendors, policy makers, and
everyone else in the healthcare delivery
system will improve nearly every aspect
of our healthcare model. So when you
are putting in the hours to learn and plan
for the change to ICD-10, remember the
bright side: our healthcare delivery system
will improve.
HCAF
Jose Serrano is the Chief Technology Officer for
Data Soft Logic. Data Soft Logic delivers forward
thinking technology solutions including web-based
software. HCAF wishes to thank Data Soft Logic for
their support of both our 2015 winter and summer
conferences. To thank them for their support or for
more info, please see datasoftlogic.com.
“ I T I S E X P ECTED THAT THE
US E OF I CD - 1 0 WI L L R E SULT
I N L E S S COD I NG E RROR S
B ECAUS E THE S ET I S L E S S
AMB I GUOUS , MOR E DETA I L ED ,
AND B ET TE R ORGAN I Z ED
THAN P R EV I OUS CODE S ETS ”
