Study: ICD-10 Codes Could Pose Problems for Emergency Physicians

May 26, 2015
As the healthcare industry moves towards ICD-10 from ICD-9, researchers recently revealed that many emergency physicians may find trouble with reimbursement under the new code-set.

As the healthcare industry moves towards ICD-10 from ICD-9, researchers recently revealed that many emergency physicians may find trouble with reimbursement under the new code-set.

Researchers from the University of Illinois at Chicago, which has tackled the issue of mapping from ICD-9 codes to ICD-10 numerous times before, found that emergency physicians may have trouble justifying hospital admissions and reporting certain diseases to public health departments in the new code-set. The UIC researchers developed a tool that reports the ICD-9 to ICD-10 code mappings, revealing some of the potential challenges certain areas of a healthcare organization may face during the transition.

The researchers found that 27 percent of the 1,830 commonly used emergency room ICD-9 codes had convoluted mappings that could create problems with reporting or reimbursement. Moreover, researchers looked at more than 24,000 actual clinical encounters in the ER and found that 23 percent could be assigned incorrect codes if recommendations of the Center for Medicare and Medicaid Services (CMS) were followed.

"Despite the wide availability of information and mapping tools, some of the challenges we face are not well understood," Andrew Boyd, M.D., assistant professor of biomedical and health information sciences at UIC and principal investigator on the study, said in a statement.

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