ICD-9 (for now)

Ok, last of the boring stuff, I promise... at least for a while.

The last reference manual that you will need to deal with is the ICD-9.  Exactly like the last two examples (the CPT and the HCPCS) it is separated into two major sections, alphabetical and tabular.  But wherein the last two books dealt with procedures, drugs, and equipment (primarily), the ICD-9 lists diagnoses.  It is an extremely detailed listing of any illness, condition, pre-condition, post-condition, or injury that you could imagine.  Again, like the other two books you never want to code from the alphabetical section, but use that as a reference to get to the much more detailed tabular section.  Below are two page examples.

So why do we need the ICD-9 anyway?  To track healthcare trends, and also to aid the insurance companies in processing your bill.  If your policy excludes certain services, like pregnancy for example, and a claim comes through with a pregnancy diagnosis, that aids the insurance company in the denial of that claim.  Many policies have a different payment rate for Emergency Room services.  A trauma or injury diagnosis will help expedite this.

The government also uses this information to allocate funds for healthcre trends and crises, such as AIDS, or pandemic flus.  The government gets a report of all reported diagnoses (without the names associated with them) so that they can determine what action needs to be taken next (if any) regarding the state of healthcare in the country.

Interestingly, the rest of the world also uses the ICD-9, its successor the ICD-10, and in 2015 will be using the ICD-11.  The World Health Organization tracks global pandemics and other health issues as well.  We are the only country that utilizes the ICD-9 for billing, making conversion to the ICD-10 much more difficult.

Next post will contain a listing of the major setions of the ICD-9 book.  Then on to the nuts and bolts of beginning a home business.

Until next time,

Thanks,
Lori

http://www.sinclairinkspot.com/
Loretta Sinclair
Author, Medical Billing, Coding and Reimbursement
How to Run Your Own Home Medical Billing Service
Annotation Press, 2007, 2008
Available in print and on Kindle

Medical Billing, Coding, and Reimbursement
Supplemental Workbook
Sinclair Publications
copyright 2009

http://www.medicalbillingservice.blogspot.com/
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