September 29, 2017
A required change in the way businesses must report workplace injuries may help your company save money. The full name for the updated process is: International Classification of Diseases, Modification and Procedural Coding Systems, Revision 10. But the commonly used abbreviation is ICD-10. After several delays, ICD-10 became effective in October 2015, for all employers, agencies and other entities covered by the Health Insurance Portability and Accountability Act.
ICD-10 classifies and reports work-related illnesses and injuries to federal officials. The requirement also affects workers’ compensation insurance carriers and claims administrators. Before October 2015, employers used the ICD-9 coding system to track workplace injuries. But this system was gradually becoming obsolete. The categories available didn’t reflect the substantial medical progress made in the last 20 to 30 years. Federal programmers tried to modify it periodically to keep up but, ultimately, the platform just wasn’t flexible enough to adapt.
Revision 10 is significantly more articulated than the legacy system, with five to seven coding characters instead of three to five under ICD-9. The newer version also has two sets of codes:
- Inpatient procedure codes, which are normally used in hospitals, and
- Diagnoses codes, which are common to all health care settings.
Between the two, ICD-10 features more than 14,400 unique codes, which will enable officials and researchers to track many new diagnoses, as well as communicate more specific diagnoses and conditions. Indeed, ICD-10 empowers officials to track much more information than they could using the older platform.
For example, under ICD-10 the entry for atrial fibrillation allows health care providers to enter a different code for chronic atrial fibrillation, which lets coders note the chronic nature of the condition without necessarily increasing the severity of illness (SOI). The ICD-10 coding system has important implications in suggesting different courses of action regarding treatment, and may help control treatment costs.
Because ICD-10 is so much more specific and finely articulated than ICD-9, companies that employ utilization management systems may be able to save significant money in treating employees injured or sickened on the job. The system also helps employers better track outcomes, illnesses and injuries — and help them get reimbursed appropriately for payments.
ICD-10 is mandatory for all incidents on or after October 1, 2015, but employers can also use the ICD-10 system for previous events and occurrences. However, managers should take care that each injury or illness is inputted into one system only. Don’t try to duplicate the same event in ICD-9 and ICD-10.
ICD-10 Tips for Employers
- Consider using ICD-10 for major events resulting in serious illness or injury that occurred before October 1, 2015, assuming the events weren’t already reported on ICD-9.
- Test report your systems for compliance before going live.
- Use software tools that make it very simple for your HR workers and workplace safety/injury administrators to find the new codes, or automatically convert the ICD-9 codes to ICD-10 codes.
- Keep training risk management staff, line supervisors, workers and everyone else involved in workplace safety on how to enter conditions using the ICD-10 codes.
- Work with your bill review agents to scrutinize your records for discrepancies for any injuries occurring prior to October 1, 2015.
Expect challenges. Every updated system means a lot of man-hours in learning and the occasional glitch. But the ICD-10 coding system’s benefits, in the long run, are well worth it.