Medicare Compliance & Reimbursement

3 hidden advantages make the learning curve worthwhile.

If the sheer volume of new diagnosis codes in ICD-10 has got you worried about the prospect of transitioning to the new coding system, then here's the good news. ICD-10 offers hidden benefits that could help rather than hinder your claims processing -- and make your life easier.

You've likely heard that ICD-10 will offer greater specificity, but check out these three additional reasons that ICD-10 could help your practice significantly from Richard Tuck, MD, FAAP, pediatrician at PrimeCare of Southeastern Ohio in Zanesville.

1. More detail for preauthorization medical review. Anyone who has ever sought insurance preauthorization is well aware of the hurdles involved. Thanks to ICD-10, that process might be a little easier, since the payer will get a more complete story of the patient's condition due to the detail in ICD-10 codes. With more information, the payer will be less likely to return to you for additional information, which can slow approvals and payment, as well as create additional work for you.

2. Improved ability to measure health care services. Due to ICD-10's specificity, payers will be able to determine the number of patients with certain conditions who are seeking specific services. In cases where payers are on the fence about whether to pay for particular procedures, the use of ICD-10 will assist in showing the insurers the value of payment for these services.

3. Supports patient-centered primary care. With the expansion of the diagnosis code set, physicians will have more detail to support effective engagement and interventions, and will be able to more accurately communicate the patient's conditions to other practitioners involved in the patient's care.