10 Ways ICD-10 Will Improve Quality of Care

Cheryl Clark, for HealthLeaders Media , December 1, 2011

2. Improves public health tracking

ICD-10 improves the ability of public health officials to track diseases and threats, dangerous settings and even acts of bioterrorism that might otherwise go unrecognized. 

It "is more specific and fully captures more of the public health diseases examined than ICD-9," says a paper by Valerie J.M. Watzlaf, [PDF] professor of health information and management at the University of Pittsburgh.  Information was better for capturing reportable diseases, the top 10 causes of death, and illnesses related to terrorism.

For example, ICD-9 has no way of classifying certain serious foodborne illnesses, such a clostridium perfringens, but ICD-10 does. And ICD-10 is much more specific about syphilis, HIV and pneumococcal infections.

3. Discourages upcoding, fraud

One potential for ICD-10 is that with more specificity, it will be a lot tougher for hospital coders to lump patients into a more severe disease or procedure category. Bowman says, "In an ICD-9 world, codes are more ambiguous," says Bowman.

"It will be harder for people to, when they encounter something that seems initially like it's on the border of one code or another, to say, 'I think I can get this into this (higher paying) code.' We'll be seeing a lot less of that with ICD-10."

For example, ICD-10 features a way of identifying each side of the body.  Bowman says that if a patient seems to be having numerous procedures on the same foot, either the treatment "isn't effective" or it may be a billing misadventure, she says. "It helps with fraud, because payers can check for multiple encounters/treatment for the same anatomical site."

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8 comments on "10 Ways ICD-10 Will Improve Quality of Care"

Jennifer Hamilton (1/12/2014 at 8:02 AM)
At the same time the public is demanding the US government "back off" on collecting information, medicine is about to introduce a dramatic increase in "data" for our government. And, please note, it will be tied to your electronic medical record. It is hard to argue with the need for updating the codes, but the dramatic increase in numbers, details and specifics is of concern. The cost will be real in time and money. To argue that one benefit is that it preserves and even grows the number of coders is shocking- increasing people who push paper and provide no care at the same time we are trying to cut cost?! This is a fantasy article by someone who has no clue what providing health care is about.

ralph (2/17/2012 at 12:48 PM)
I'm trying to understand how going from 14,000 CPT billing codes to 140,000 ICD-10 billing codes improves quality of medicine? It might improve the quality of live of bean counters who have to sort through this mess, but thats it. Thats why at www.medibid.com there are no billing codes, and patients save about 80% off of the billed rates

patient advocate (12/2/2011 at 2:30 PM)
Physician practices are provided with a substantial amount of money to ease the burden of modernizing their practice to use EHRs, and transitioning to ICD10 is certainly part of that. A $40,000+ investment by American tax payers that is available to all physicians that adopt new HIT technologies is a far cry from "and do it all at my own costs".




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