How will ICD-10 improve quality of care?
ICD-9-CM classification has not been able to fully integrate new changes and advancements in medical field. In the present scenario, over 30 years old ICD-9 classification system is outdated, vague and does not provide sufficient codes to document exact patient’s condition. Therefore, it may not provide a true reflection of a patient’s condition; potentially affecting quality of patient care. Consistent, accurate and precise coding, which are the fundamental elements of quality, make many direct positive impact on the quality of patient care. In the contrary, inconstant disease reporting and lack of quality data affects the outcome adversely.
ICD-10 has major improvement and modification in coding primary care encounters, external cause of injury, mental disorders, neoplasms and preventive health. Capturing the exact patient diagnosis with ICD-10 implementation will have the greatest positive impact on the overall quality of patient care. Moreover, ICD-10 provides coding system to capture severity, condition, and location of disease more precisely. This helps clinicians to make better treatment decisions by using more accurate diagnosis codes. For example, in the condition of expansion in diabetes mellitus related manifestations, ICD-10 provides combination codes for conditions and common symptoms codes to fully describe a condition.
In addition, ICD 10 has potential to incorporate with new codes when there will be new disease, procedure, device and technology available. Also, ICD-10 codes mapped with standardized nomenclature and compliance enables clinicians to use decision support system available with EHR system more effectively. It will bring big positive change in the quality of care by guiding clinician with valuable information.
Further, ICD-10 will improve the quality of data being collected and better data quality will bring positive impact in the data mining process as well. More specific data will help to collect the more real public health statistics in the U.S. and around the world, as well as helps researchers to obtain more accurate research results. It will help with monitoring public health risks and track, compare new and existing disease elements. It will, in turn will improve overall quality of public healthcare. More useful data will help to determine the quality of patient care as well.
ICD- 10 offers a better system to determine payments for patient care by offering more detail documentation and coding. Timely, accurate, and complete coding will minimize the chance of claim rejection and will help to enhance more accurate reimbursement process.