Will ICD-10 provide more accurate reimbursements?

Aug 12, 2014 | Health Insurance Billing

The Centers for Medicare and Medicaid Services (CMS) have set the latest deadline for ICD-10 compliance for October 1, 2015. The previous update, ICD-9, is now over 30 years old, and considered outdated and unusable for today's treatment, reporting and payment processes, according to the American Medical Association.

However, care facilities and providers are not all excited about the arrival of the latest version. The industry has long called for a coding system that would address both doctors' needs for care delivery and health care businesses needs for a system for more accurate reimbursements. Dr. William Bria, president of the Association of Medical Directors of Information Systems, is not convinced that the ICD-10 is the answer for both these needs. 

Some providers prefer the even more detailed SNOMED coding system, Dr. Bria explained. The split comes between a focus on physician-facing benefits and business-facing benefits, and SNOMED better helps physicians understand disease processes and the success of certain treatments than ICD-10 would be able to, Bria argued to Modern Healthcare.

"We're trying to disambiguate the costs of healthcare with the services rendered, then why are we trying to confuse the situation?" Bria asked the source. "Why don't you use the one that makes more sense to the people who actually know healthcare?" which, Dr. Bria argued, would be the SNOMED system. 

The release of ICD-10 has been pushed back several times, frustrating facilities and leading many providers to seek alternatives. But as this blog has explored extensively in the past, there is a national issue of the transparency of health care costs that needs to be addressed. Accounts receivable management professionals will have to wait and see whether the use of SNOMED or ICD-10 will bring about the desired result.