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Medicare now requires physicians and all healthcare providers to send claims with ICD codes of highest specificity. However, since its launch in October 2015, physicians have faced several challenges with ICD-10 coding. Such challenges fall under the following categories.
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Getting Paid: ICD 10 Specificity Challenges & Innovative Technology Solutions for Physicians

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Table of Contents

ICD-10 (International Classification of Diseases) is divided into two main categories:

  1. ICD-10 Clinical Modification (ICD-10 CM): captures diagnoses in every healthcare system
  2. ICD-10 Procedure Coding System (ICD-10 PCS): captures inpatient setting procedures

Medicare now requires physicians and all healthcare providers to send claims with ICD codes of highest specificity. However, since its launch in October 2015, physicians have faced several challenges with ICD-10 coding. Such challenges fall under the following four categories:

Documentation

Diligent noting of multilayered details in the appropriate manner is required for ICD-10 coding, which can be a challenge for physicians documenting within EMR

EMR/EHR

Unfortunately, EMR/EHR inadequately guides physicians to provide specific ICD-10 codes. Consequently, mobile charge technology for ICD-10 coding can be complex and problematic for many physicians.

Compliance

Since ICD-10 coding expects nothing short of accurate coding, physicians are more likely find themselves facing error in coding specificity when it comes time for audits.

Code Specification

ICD-10 requires numerous codes which need to be specified. Such may include coverage and policy alterations. Failure to code with highest possible specificity leads to claim rejection, auditing risk, and delay in payment.

POTENTIAL FINE AND FRAUD ALLEGATIONS FOR MISCODING

Repercussions for improper coding cannot be overlooked. Such may come from both sides: the employer and insurance companies (including Medicare and Medicaid). In most cases, health providers are fined while other cases may take into account the inaccuracies of the coder. Therefore, taking the time to confirm diagnosis with accurate ICD-10 codes is significantly important for physicians or health care providers.

Insurance companies may decide to impose the liability documented in the Federal False Claims Act, accusing a coder for knowingly submitting a false claim for payment. Fines imposed by the employer may vary depending on employment agreement which defines financial fines and penalties.

TECHNOLOGY SOLUTIONS FOR ACCURATE ICD-10 CODING

The following technology-based remedies can aid as a prevention measure to finding oneself on the wrong side of ICD-10 coding practice:

THREE FEATURES DOCCHARGE USES TO IMPROVE CODING SPECIFICITY AND SAVE TIME

DocCharge, a mobile physician productivity platform, tackles the challenges with ICD-10 in an easy-to-use, effective manner. The following 3 features explain how:

About DocCharge

DocCharge: Be productive again! Practice analytics, mobile charge capture, HIPAA compliant messaging, and tools for billers.
DocCharge is a mobile physician productivity platform enabling physicians and clinicians to save time by efficiently capture patient billings, communicate with back office and maximize revenue by avoiding lost charges using real-time analytics on a mobile device. Designed by a physician for fellow physicians, residents/fellows, and mid-level providers, DocCharge maximizes one’s productivity. Practice Administrators and outsourced billing companies find the application very intuitive, thus improving practice efficiency and revenue.
DocCharge is transforming healthcare data into useful and actionable insights, thereby allowing partner subscribers to focus their resources on the core business of providing high quality patient care. For more information, visit www.DocCharge.com, email: contact@DocCharge.com.

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