Benefits of ICD-10

By contrast, ICD-10 provides more specific data than ICD-9 and better reflects current medical practice.

The added detail embedded within ICD-10 codes informs home health agencies and health plans of patient incidence and history, which improves the effectiveness of case-management and care-coordination functions. Accurate coding also reduces the volume of claims rejected due to ambiguity. The new code sets will:

• Improve operational processes across the health care industry by classifying detail within codes to accurately process payments and reimbursements.
• Update disease classifications to be consistent with current clinical practice, medical and technological advances.
• Increase flexibility for future updates as necessary.
• Enhance coding accuracy and specificity to classify anatomic site, etiology, and severity.
• Support refined reimbursement models to provide equitable payment for more complex conditions.
• Streamline payment operations by allowing for greater automation.
• Provide more detailed data to better analyze disease patterns and track and respond to public health outbreaks; the United States will join the rest of the developed world in using ICD-10, and will be able to compare public health trends and pandemics across borders.
• Provide payers, program integrity contractors, and oversight agencies with opportunities for more effective detection and investigation of potential fraud or abuse and proof of intentional fraud.
• Provide more accurate information to support the development and implementation of important health care policies nationally and regionally.

ICD-10 codes refine and improve operational capabilities and processing, including:

1. Detailed health reporting and analytics: cost, utilization, and outcomes

2. Detailed information on condition, severity, co-morbidities, complications, and location

3. Expanded coding flexibility by increasing code length to seven characters