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Built-in or Bolted-on ICD-10: What’s the Difference and Why Does it Matter?

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bar chart with 425% increaseMost doctors, if not their office managers, are aware of the impending change in medical diagnostic billing codes that will take effect in the third quarter of this year. Medical practices will have a massive adjustment beginning on October 1, 2014, with the introduction of the 10th revision of the International Statistical Classification of Diseases (ICD), a medical classification list by the World Health Organization (WHO). Diagnostic codes will rise from 13,000 to more than 68,000 ? a nearly 425% increase. Proper knowledge and use of the codes in billing for services will determine if doctors get paid.

Most technology offerings for ICD-10 involve code look-up or general equivalence mapping (GEM), an attempt at translating ICD-9 codes to the new codes. That method seems simple in theory, but is convoluted and can be ineffective in practice. GEM, other translation tools, and conversion software all have one thing in common: they aim to redirect you from the old ICD-9 code to the appropriate ICD-10 code, but the increase of codes and their complexity may make exact matches difficult if not nearly impossible.

 

ICD-10 crosswalkThere are quickly becoming as many solutions offered for ICD-10 as there are new codes. It?s hard to keep them straight. And many vendors, including electronic medical records (EMR) system vendors, will say they are ICD-10 ready, but this could imply that they are merely using mapping or translation tools rather than having built-in, intelligent coding.

Just having 68,000 codes in your EMR system to choose from in long lists isn?t a time- saving or cost-effective option. For efficiency, billing codes should generate effortlessly right along with your exam notes. Your EMR system should be built around ICD-10 ? it should be its ?native tongue?, and not have ICD-10 conversion bolted-on.

What questions should you ask your EMR or EHR system provider to ensure your EMR system’s ICD-10 solution is built in, not bolted on? Click here to download the white paper to help guide you through the process and learn the seven most important questions to ask before ICD-10 kicks in.