ICD-10-CM Starts Today in the U.S.A.!

by Michaeleen OSullivan, CCS, CCS-P
Marquette, Michigan
October 1, 2015

ICD-10-CM Starts Today, October 1, 2015, in the U.S.A.

Today the U.S.A. healthcare world begins using ICD-10-CM codes. Providers will consult ICD-10-CM codes in their efforts to diagnose diseases and problems. Providers will collect ICD-10-CM codes and their associated descriptions to share health information with patients, with other healthcare professionals, with payers, and with policy makers.

ICD-10-CM Promotes Best Practices of Patient-Centered Healthcare

ICD-10-CM will work best when providers use best practices of patient-centered healthcare. To achieve success going forward, providers will need to record more specific detail about healthcare encounters. Unspecified diagnoses that were reimbursed in ICD-9-CM may no longer be reimbursed in ICD-10-CM.

Providers will listen to patients more carefully. Providers will explain diagnoses to patients in more detail. Providers will link up diagnoses with treatments. Providers will ask for patient input in regard to weighing benefits and risks of treatments.

Patients will become the center of healthcare encounters and discussions. Health information will be carefully documented within standard healthcare formats. Advancing patient-centered healthcare is a major benefit of implementing ICD-10-CM in the U.S.A. as of today.

Adoption of Electronic Health Records (EHRs)

Providers communicate health information through various formats. Providers promoting best practices will implement certified electronic health record (EHR) systems. EHRs will help providers to produce best quality outcomes. Within EHRs, health information will be communicated most efficiently with as much detail available.

Providers Must Authenticate Healthcare Reports

EHRs remind providers to authenticate their reports. Authentication is an important element missing from many healthcare reports today. To achieve best outcomes, it is essential providers identify themselves in their reports with legible name and credential(s).

Healthcare Fraud Costs the U.S.A. $100 Billion Per Year!

ICD-10-CM will result in positive financial outcomes for the people of the U.S.A. The level of detail ICD-10-CM will require, and the adoption of certified EHRs, will make healthcare fraud easier to catch and to defeat. Healthcare fraud is currently estimated to be costing the U.S.A. at least $100 billion per year!

Misclassifications in ICD-9-CM

Healthcare professionals have been preparing for ICD-10-CM for 20 years. We understand the benefits. We also understand the misclassifications in ICD-9-CM.

One of the most obvious examples to explain misclassifications in ICD-9-CM relates to tobacco dependence. There is no main category for tobacco or nicotine dependence in ICD-9-CM. Tobacco dependence is obscured within a misclassified category entitled "Nondependent Abuse of Drugs."

ICD-10-CM corrects misclassifications in ICD-9-CM. In this example, ICD-10-CM contains a main category, F17 Nicotine dependence. ICD-10-CM contains separate categories for tobacco exposure and use. In addition to assigning tobacco codes as principal or first-listed diagnoses when applicable, ICD-10-CM requires tobacco exposure, use, or dependence to be assigned as additional codes to many related diseases.

Request Copies of Your Healthcare Records!

The new world of patient-centered healthcare will work best when we request copies of our records. To request your health records, fill out and sign the request form when you check out from your healthcare encounter.

You may receive a printed Summary of your visit at checkout. The Summary is usually only a brief account of your actual encounter. Your actual healthcare report will contain much more information, including a detailed plan for your treatment, which is important for you to know, to understand, and to follow, or to not follow and to seek care elsewhere if warranted.

When you fill out a request for health records, check the box "for continuation of care." Most provider offices will not charge for copies of your records for continuation of care. If you choose "for personal use," some providers may send you a bill for copies.

Please read your reports carefully and verify the information is accurate. Verify your healthcare reports are authenticated by your rendering provider, including signature with legal name and credential(s).

You have the right to request an addendum to your healthcare report if you find information is missing or if you feel information is unclear, confusing, inaccurate or misleading.

Let Us All Welcome ICD-10-CM Today!

Let us all welcome ICD-10-CM together today! The participation and diligence of each American is required to achieve the desired outcome of improved healthcare for all and to help decrease massive healthcare fraud in the U.S.A.

About the Author:

Michaeleen OSullivan is co-owner and contributing author of UP First Wild Arts and UPfirst.com. Michaeleen is a Certified Coding Specialist, both Hospital and Physician. Michaeleen works from home in Marquette, Michigan, as an auditor with an international healthcare team. Michaeleen has worked as a coding and documentation specialist, educator, and author for more than 30 years.

About the Editor:

Todd Carter is co-owner, contributing artist, and editor of UP First Wild Arts and UPfirst.com. Todd is a folk artist, painter, and graphic artist. Todd's artwork is featured throughout UP First Wild Arts and UPfirst.com. Todd has worked as an artist, educator, computer specialist, and editor for more than 30 years.

References:

Health care: A 'goldmine' for fraudsters, CCN Money, January 13, 2010, http://money.cnn.com/2010/01/13/news/economy/health_care_fraud/, accessed 9/19/15.

International Classification of Diseases, http://www.who.int/classifications/icd/en/ accessed 9/14/15.

International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), http://www.cdc.gov/nchs/icd/icd10cm.htm, accessed 9/14/15.

International Statistical Classification of Diseases and Related Health Problems, From Wikipedia, the free encyclopedia, https://en.wikipedia.org/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems, accessed 9-14-15.

Medicare FAQs, How Much Money Is Lost to Medicare Fraud Annually?, http://www.medicarenewsgroup.com/news/medicare-faqs/individual-faq?faqId=6a130489-e387-476d-a358-c77cfba68367, accessed 9/19/15.

Report Fraud, Office of Inspector General, U.S. Department of Health & Human Services, http://www.oig.hhs.gov/fraud/report-fraud/index.asp, accessed 9/19/15.

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