EMERGING CHALLENGES IN MEDICAL CODING
It’s time to take a look at the insights and trends in the Medical Coding space. The reason why this becomes so important is the rules keep changing very frequently. First there was ICD-10 transition which was about to create a storm in the US healthcare space. But the transition got postponed to next year. That itself created another storm as most of the healthcare set-ups were geared up for the transition and invest tons of money into transition, training their employees and get them certified. The second one is the influence of the ACA – Affordable Care Act. This has increased the breadth of coding to a huge extent and in-turn requiring coding man power that is less available today. The third factor influencing medical coding to a large extent is the CPT code updates. Those frequent upgrades are a synonym to the word “Ever Changing”.
Let us now look at the these three factors in details and how this would affect you:
- The ICD-10 Transition (So Called):This we see as one of the major concerns. Surely this changing the way Medical Coding has been done over the past many years. While some hospitals and healthcare set-ups are ready at the moment as they have done their ground work, most are not. This is the testimony to the fact that the transition got revoked. To put it differently, it is a big deal for many. It’s not difficult to learn ICD-10 for those who have been doing it for year, but at the same time it is very difficult to unlearn the old ways of doing things. Imagine the amount of errors and denials that would pop-up. To put it in numerical terms for those who like to see things more practically, ICD-9 contains 3,824 procedures codes and 14,025 diagnosis codes. Whereas ICD-10 on the other hand contains 71,924 procedure codes and 69,823 diagnosis codes. Now that’s a lot of codes to learn. So to aggregate, you need to learn 141,747 new codes and unlearn 17,849 old codes. That itself is 794% more codes. These are some of the perspective and there are many. While these sounds as issues, there are distinct advantages of moving to ICD-10 as it describes the encounters much more in detail compared to ICD-9.
- The Affordable Care Act:This has made a huge impact in the healthcare industry and has also impacted healthcare jobs to a large extent. This is due to a large population of Americans who are not eligible for medical care. So, needless the explain the increase in number of procedure codes that needs to be documented. ACA has now put very strict regulations in place to ensure the coders do their best. This will not only increase the payment accuracy but also the time lines.
- Updates to (Current Procedural Terminology) CPT Codes:There are thousands of codes as mentioned above. And changes to these occur more frequently than updates to ICD. Frequent changes means, coders have to be up to date with the updates to CPT codes otherwise they would end up coding incorrectly which will have a direct impact on the reimbursement, either less or delayed or denied.
Healthcare Organizations and Medical Coding companies have to take note of these challenges and move forward with a strategic plan in mind. Promantra is one such organization that at first gives importance to updates and providing the right amount of training to its employees in Medical Coding. This has enables them to be one of the global players in the Medical Coding space.
For more information about our Medical Billing Services, call 1-732-414-3678 and speak to one of our experts.
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