ICD 10s...They're Not Just for Billing Blog Feature
Jim Leonard

By: Jim Leonard on July 30th, 2014

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ICD 10s...They're Not Just for Billing

Healthcare Provider Credentialing

Patient Safety, Quality, ICD-10October 1, 2014... Is the date that’s top of mind with most healthcare providers, payers, clearinghouses, and billing services since CMS (Centers for Medicaid & Medicare Services) announced this as the final deadline for the transition to ICD 10. With the technology, training, and changes required, it’s going to take an inordinate amount of time just to get the 10’s implemented let alone consider the number of ways we’ll all benefit from this change. Yes, the requirement is burdensome, but if we take a moment to think ahead, it’s easy to understand that transitioning to ICD 10s will have a dramatic and positive impact on many areas of healthcare:

Quality Control

Just the thought of going from 18k to more than 140k codes says more than just billing; it screams quality control. ICD 10’s will provide granular insight into what providers are actually doing as well as provide more detailed information regarding the effectiveness of procedures and subsequent treatments.

Disease Management/Patient Safety

More accurate classification means improved monitoring of patients with chronic diseases to:

  • Ensure they’re receiving the correct quality of care

  • Tailor programs to meet their unique needs

  • To prevent potential risk of complications

Provider/Practice Insight

With ICD 9s, new procedures are lumped together with older procedures making diagnosis more difficult and ascertaining accurate statistics very challenging. With ICD 10s, the additional codes will allow procedures and techniques to be more clearly differentiated which will give providers and practices the ability to mirror procedures and truly measure outcomes.

Fraud Reduction

Accurate documentation of care provided is vital, not only for healthcare quality but to reduce fraud. Utilizing ICD 10 codes will allow providers to be more descriptive and accurate while eliminating many 'gray areas' where fraud is often found.

The transition to ICD 10 is long overdue and if it wasn’t for the complexity and expense of implementation it would have been required sooner. Regardless, the change is necessary and it will be very interesting to see all the positive changes, in addition to the ones mentioned above, stemming from this. Hopefully, we'll look back on this in three to five years and wonder why it ever took us so long!


About Jim Leonard

Jim serves symplr as the business development leader of Provider Management and Payor Enrollment. He brings more than 20 years of highly successful sales, marketing and consulting leadership to symplr. His team’s focus is to aid clients with the identification and resolution of gaps in current credentialing, privileging, peer review, quality, and event reporting programs. Jim’s insight into utilizing technology to create transparency and improve operational efficiency promotes overall improvement in provider and hospital performance; further aiding clients in meeting or exceeding compliance with governing body requirements such as CMS, JC, DNV, and CIHQ.