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Case Study: How ICD-10 Impacts Healthcare

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The World Health Organization established the International Classification of Diseases (ICD) to standardize medical records. ICD-10 is an update that reflects changing needs in medicine. The code offers increased detail and flexibility. However, implementing the code presents medical establishments with several challenges. The biggest challenge is finding common ground between the two frameworks.

How ICD-10 Impacts Healthcare

A presentation published by the Centers for Medicare and Medicaid Services explains that the World Health Organization created ICD-9 in 1979 to reflect current medical advances and establish universal coding procedures. [1] The system outlines the diagnoses, procedures and terminology used by caregivers. Medical organizations …show more content…
It will reflect current medical practices and allow physicians to make changes as needed. The classification system will allow caregiver to provide more detailed information about injuries and procedures. Additionally, the system will allow physicians to describe in detail how they performed the procedures.

This enhanced reporting ability is not without shortcomings. The increased data will initially slow classification workflow until caregivers adapt to the new system.

Five: Changes for Medical Record Departments

A report authored by Alexa Arends-Marquez, et al on the American Health Information Management Association (AHIMA) forecasts that ICD-10 implementation will initially slow insurer processing. [3] Caregiving facilities will see backlogs in financial processing in areas such as:

• Scheduling
• Pre-certification
• Pre-registration
• Estimates
• Registration
• Case Management

Caregivers will have to educate staff members and patients on adapting to the new system and providing or obtaining the right information to complete processing. Additionally, caregiving facilities will have to revise their procedures to accommodate the new …show more content…
This creates the possibility that overwhelmed finance departments will leave many procedures un-coded.

Challenges of Initial ICD-10 Implementation

A report issued by Medicaid reveals that the largest challenge present by ICD-10 implementation is that there is no clear way to switch to the new outline. [4] A new code may correspond with a single or several ICD-9 references. Conversely, one ICD-9 code may correlate with a single or several ICD-10 references, and some codes new classifications do not correlate with any references in the ICD-9 framework. As a large healthcare insurance outlet, this creates major implications for Medicaid. State agencies have produced documentation to assist with this process, but only time will tell if these aids will help caregiving facilities make the upgrade to

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