ICD-10 Data: Why U.S. healthcare needs to move on from ICD-9 coding

Jason Gottlieb

by Carl Natale, ICD-10 Watch

When ICD-10 opponents say there is no benefit for patient care, they’re refusing to connect data to healthcare. It’s not hard to see why.

It’s not like physicians can see a patient recover as their symptoms are documented. So there’s no clinical reason why U.S. healthcare needs more data.

Except data isn’t medicine. It doesn’t work that way. It accumulates over time to give healthcare professionals a picture of how treatments and diagnoses develop. That data can give physicians better ideas on how to treat their patients.

How much ICD-10 data do we need?

It’s hard to understand why U.S. healthcare needs data on turtle and jet engine injuries. Except someone with a medical degree argued for the inclusion of some “bizarre” codes. But those kinds of diagnosis codes are relatively few. There are more important specifics to focus on:

  • Much of the specificity is due to laterality (right or left side).
  • Also the new details included in the codes will help link symptoms and identify patients at risk of developing serious health problems.
  • The precision allows for better tracking of care after the initial patient encounter. The information can be used to develop better care after treatment.
  • Such specificity will help identify fraud, waste and abuse in medical claims. “Was the same procedure performed twice? Were conflicting claims filed for the same patient?”

And the better, more precise the data will help physicians make better decisions because they can see trends if they look at healthcare data.

How much time do we need for ICD-10 data to matter?

Again, the problem with this is that it’s going to take time to realize those benefits. Physicians and patients like short-term benefits. Take your medicine and you start to feel better in days or weeks. But it could take years to see these benefits.

All the knowledge that physicians use to diagnose and treat patients took years or decades or centuries to accumulate. Medicine is the result of careful study that takes time. And ICD-10 codes will help them accumulate data that leads to new treatments.

Will ICD-9 codes kill anyone?

Not likely. But medical uncertainty can. And it’s practically impossible to connect that with a lack of specificity in ICD-9 codes.

Just a little more specificity has got to help. And maybe ICD-10 codes can give us enough information about what we do not know that U.S. healthcare can advance treatment.

It’s a big maybe that comes at a cost for medical practices. But physicians deal a lot in maybes when they diagnose patients. Let’s use ICD-10 codes to get rid of a few maybes.