ICD-10 Implementation as Quality Improvement
HHS will allow insurers to count a certain percentage
of their ICD-10 conversion costs as a
quality improvement activity. ICD refers to the
International Statistical Classification of Disease and are alphanumeric
designations given to every diagnosis, description of symptoms and cause of
death. ICD codes are widely used in medical billing by insurers, as well as for
research and other purposes. These codes will become increasingly important as electronic
medical records are implemented.
HHS had initially proposed that health insurers would
have to convert their billing systems from ICD version 9 (ICD-9) to ICD version
10 (ICD-10) by October 1, 2013. However, they have
extended that deadline to October 1, 2014. For an
insurer’s MLR calculation, HHS has stated that ICD-10 conversion costs that
account for up to 0.3% of
an insurer’s premium revenue can be counted as quality improvement activities
for the 2012 and 2013 reporting years which could increase their MLR slightly.
Any additional costs for ICD-10 maintenance and claims
adjudication systems would count as administrative
costs under the MLR rule. To the extent these additional costs exceed 0.3%,
they would reduce the denominator and could reduce the MLR.
Given the importance of ICD-10 and the required transition of the Health
Plans , physicians are required to be prepared for the conversion to ICD-10 in October 2015.
The time to prepare is NOW.
AccuChecker is The Complete Tool For Medical Reimbursement.
Designing ICD-10-CM our main concern was implementing the best retrieval
techniques in searching, extracting and selecting the correct diagnosis codes
and presenting the ICD-10-CM information like in a book format and at the same
time delivering in www.accuchecker.com the most
comprehensive, fastest and accurate ONLINE system in the healthcare industry.
Ask for a demo and compare our ICD-10-CM to the most expenses systems in
the market – compare feature by feature and then compare our prices – AccuChecker
OnLine Product Line applications including our ICD-10-CM gives the highest
return on investment to any medical software in the nation.
How do we present the ICD-10-CM Codes?
AccuChecker OnLine ICD-10-CM lists the most common description identifier
of a diagnosis code and also displays synonyms or names that are identified by
the same code and the same condition.
Level of Detail in
Coding:
ICD-10-CM Diagnosis codes are to be used and reported at their highest
number of digits available. They are composed of codes with 3, 4, 5, 6 or 7
digits.
Seventh character and placeholders:
Some codes require the use of a seventh character for codes in chapters.
If there are fewer than six characters in the code (not counting the
decimal point) the placeholder "x" is used to ensure that the seventh
character is always in the seventh position.
Includes:
The word "Includes" appears immediately under certain categories
to further define, or give examples of, the content of the category.
Excludes Notes: ICD-10-CM has two types of excludes notes.
·
Exclude 1 - Indicates that the code excluded should
never be used at the same time as the code in this section.
·
Exclude 2 - Indicates that the condition excluded is
not part of the condition represented by the code, but a patient may have both
conditions at the same time.
Code First/Use Additional Code notes (etiology/manifestation paired
codes):
Certain conditions have both an underlying etiology and multiple body
system manifestations due to the underlying etiology. For such conditions the
ICD-10-CM has a coding convention that requires the underlying condition be
sequenced first followed by the manifestation. Wherever such a combination
exists there is a "use additional code" note at the etiology code,
and a "code first" note at the manifestation code. These
instructional notes indicate the proper sequencing order of the codes, etiology
followed by manifestation.
ICD-9-CM CODES: AccuChecker OnLine ICD-10-CM also displays the ICD-9-CM
code and description of the diagnosis code, it is the “2-IN-ONE” approach:
You can use our ICD-10-CM version to operate ICD-9-CM, which means that
the staff in the office will be proficient using the ICD10 application while
using ICD9.
This will mean, that when October 2015 arrives, you and your staff are
ready for the start of ICD-10
For more details
call 305-227-2383 or 1-877-938-9311
Ask for your
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Paul G. Silverio-Benet
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