Indeed, I have to agree with David.
Probably 95% of my needs are covered by about 20 codes in ICD9. The key is to replace them with the equivalent codes in ICD10.
I too, do not care whether it is L or R, and will try to find something equivalent to NOS. Does it really matter whether an ear infection is L or R? I do know there are different codes for each.
Yes, ICD10 has more specificity. TO WHAT PURPOSE? Does it really make a difference in population management? Does it affect medical management? My answer would be NO.
The change is coding is because we always feel new is better and there are a lot of complaints about ICD9. There are plenty of codes for radiation enteritis but none specific for common Viral Gastroenteritis. Does this mean you have to triple to number of codes just to include both the common and esoteric?
ICD were originally designed as mortality codes, it was later that morbidity was considered. It has only been in the last 30 years that they have become entrenched in medical reimbursement. While there is value in associating disease with reimbursement, often this has been extended beyond it's logical conclusion to the point that we go for a code not because it has relation to the disease process. Why have 3 or 4 digit codes when only 5 digit will be considered?
Why? Because you can confuse and avoid payment. This is true at all levels. Ultimately the payors benefit from confusion. They set the rules and it will thus be to their advantage.
ICD10 is the latest iterneration. It's not the codes, its how the billing rules will set around them. That will be a lot of fun to decipher. Guess who will suffer?
Lots of question marks in this diatribe.
