The ICD-10 stands for international Classification of Diseases and other Related Health Problems, tenth revision. It is used to code diseases and signs, the related symptoms, all the abnormal findings and complaints, the social circumstances and the external causes of injury and diseases. The coding list is published and updated by World Health Organization (WHO) and is used in many other countries other than US. The ICD-10-PCS in particular means the International Classification of Disease 10 Procedure Coding System and consists of both numeric and alphabetical codes ranging from three to seven in total.
The code consists of between three to seven digit alphanumeric codes all specifying the procedure. The first digit of the code is used to indicate the area of medical practice such as monitoring, measuring, surgery and administration among other. The rest of digits indicate the body system, the root operation, the body part, the approach used and the devise used in the procedure. The seventh character is the quantifying digit.
For the purpose of reference, the first three digits are normally stored in ICD manual. A good example is a code with the first three characters as 0C0 is used to indicate a medical or surgical procedure for mouth or throat alteration. The ICD-10-PCS came as a replacement CPT code for in-patients and numbers up to 87,000 in total.
While the ICD-10-PCS are used for in-patient procedures and studies, the same cannot be used when it comes to billing of the radiologist professional components. They are also not applicable for procedures and studies concerning out-patients. The implication is that this coding system describes the procedures that are performed on in-patients but the identical procedures performed on out-patients are still described by the original CPT codes.
The auto insurance industry, legal claims and workers comps will not be converting to the new ICD-10 codes forcing hospitals to provide a mixture of CPT, ICD-9, ICD-10 and ICD-10-PCS in general management and billing system. For this reason, every player should have the capacity, ability and knowledge on when to and how to automatically convert from one coding system to the other and back. This should also be done with ease, efficiency and comfort as much as possible.
Given that some players like the auto insurance, legal claims and workers comps are not expected to convert to the new coding system, the hospitals are likely to use CPT, ICD-9, ICD-10-CM and ICD-10-PCS all at the same time. This calls for capacity evaluation, ability training and general knowledge in the part of healthcare providers to keep up to the demand of converting from one coding system to the other and back in an efficient and easy manner.
As a healthcare provider, there are no other viable options other than ensuring compliance long before the October I, 2014 date set for new system enrollment. The other options are to outsource the services or retire from the industry all together which does not seem reasonable.
The last minute rush, expect confusion and delays as hospitals, clinics, surgery centers, insurance companies, the CMS, the State Medicaid and all other healthcare providers try to comply in October 1, 2014 should be avoided. There are concerns arising from the implementation of ICD-10-PCS such as the possibility of using detailed information from this code to exclude coverage by the government and private insurance.
The code consists of between three to seven digit alphanumeric codes all specifying the procedure. The first digit of the code is used to indicate the area of medical practice such as monitoring, measuring, surgery and administration among other. The rest of digits indicate the body system, the root operation, the body part, the approach used and the devise used in the procedure. The seventh character is the quantifying digit.
For the purpose of reference, the first three digits are normally stored in ICD manual. A good example is a code with the first three characters as 0C0 is used to indicate a medical or surgical procedure for mouth or throat alteration. The ICD-10-PCS came as a replacement CPT code for in-patients and numbers up to 87,000 in total.
While the ICD-10-PCS are used for in-patient procedures and studies, the same cannot be used when it comes to billing of the radiologist professional components. They are also not applicable for procedures and studies concerning out-patients. The implication is that this coding system describes the procedures that are performed on in-patients but the identical procedures performed on out-patients are still described by the original CPT codes.
The auto insurance industry, legal claims and workers comps will not be converting to the new ICD-10 codes forcing hospitals to provide a mixture of CPT, ICD-9, ICD-10 and ICD-10-PCS in general management and billing system. For this reason, every player should have the capacity, ability and knowledge on when to and how to automatically convert from one coding system to the other and back. This should also be done with ease, efficiency and comfort as much as possible.
Given that some players like the auto insurance, legal claims and workers comps are not expected to convert to the new coding system, the hospitals are likely to use CPT, ICD-9, ICD-10-CM and ICD-10-PCS all at the same time. This calls for capacity evaluation, ability training and general knowledge in the part of healthcare providers to keep up to the demand of converting from one coding system to the other and back in an efficient and easy manner.
As a healthcare provider, there are no other viable options other than ensuring compliance long before the October I, 2014 date set for new system enrollment. The other options are to outsource the services or retire from the industry all together which does not seem reasonable.
The last minute rush, expect confusion and delays as hospitals, clinics, surgery centers, insurance companies, the CMS, the State Medicaid and all other healthcare providers try to comply in October 1, 2014 should be avoided. There are concerns arising from the implementation of ICD-10-PCS such as the possibility of using detailed information from this code to exclude coverage by the government and private insurance.
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