ICD-10: Useful Detail or Overwhelming Noise?

ICD-10 Coding Errors, Diagnostic Errors, Payment Reform. Coding Errors
It’s A Fact of Life Now, For Better or Worse.

ICD-10, with its tenfold increase in the medical billing codes (MBC) that healthcare providers and payers depend on for every aspect of medical diagnostics, treatment, and compensation, has been in place for nearly two years now. How has it worked out so far? Well, that depends on who you ask.

Useful Distinctions, or Useless Details?

The number of MBCs exploded from 18,000 in ICD-9 to over 140,000 in ICD-10, a nearly ten-fold increase. Like “drinking from a firehose,” this huge volume of specificity and detail should provide useful information, but for the provider, it’s all too often simply noise. For instance, a doctor must use a different code for an uncomplicated tibia fracture depending on whether it resulted from a slip and fall, a playground mishap, or an auto accident. This doesn’t provide valuable or relevant medical information; it’s only of interest to the insurance companies and possibly, the lawyers; but for healthcare personnel it certainly increases the time and expertise required to properly document medical procedures. That time costs money, and the exponential increase in complexity raises the stakes tremendously for the provider organization. Increasingly, those administrative costs and defensive (and revenue-maximizing) billing practices are being passed on to the healthcare consumer as increased costs.

Watch This Space for further analysis of these rapidly developing trends.