As the ICD-10 compliance deadline looms over the health care industry, some may be asking why the changeover is necessary. While the vastly increased number of codes in ICD-10 sparks fear in the hearts of many, this meticulous level of detail is actually the code set's chief benefit. The increased specificity within ICD-10 is designed to:
- Improve patient care. The increased level of detail within ICD-10 is designed to improve the ability to measure quality, safety and efficacy of care, which should ultimately lead to improved patient care.
- Improve research. For example, ICD-10 is likely to open new opportunities in injury research and trauma services evaluation, since the code set more accurately classifies the nature of injuries and correlates them with cause, treatment, and outcome. The new code set will also allow the U.S. to conduct comparative effectiveness research with other countries that already use ICD-10.
- Lend insight to the setting of health policy. With higher quality data analytics afforded by ICD-10, policy leaders will be empowered to better informed policy decisions.
- Facilitate improved public health reporting and tracking. The increased level of detail will enable agencies to track public health risks and trends in greater detail.
- Improve clinical, financial and administrative performance. The quality data afforded by ICD-10 can reveal insights into patterns of care and more. These insights enable administrators to make more informed decisions and achieve positive clinical and financial outcomes.
- Allow for monitoring of resource utilization. The ICD-10 codes will allow administrators to track the amount of time spent on procedures, enabling them to better allocate resources.
- Increase the accuracy of payment and reduce risk that claims will be rejected for incorrect coding. It is expected that the greater specificity within ICD-10 will mean fewer claim denials and more timely payment for providers in the long run.
- Reduce the need for payers to request copies of medical records. The greater specificity within ICD-10 codes should give payers more insight, reducing the need for payers to request medical records and thereby reducing costs.
- Make room for new procedures and techniques. The ability to code innovative procedures is limited by ICD-9, which has been exhausted and has no more room for new codes. ICD-10 will expand this capability to accommodate advancing medicine.