Question

Health are Data and Quality

What is the importance of ICD (international Classification of Disease) or CPT (Current Procedure Terminology) and what are the implications for billing and population health? How would the accuracy or omission of data used to determine coding affect billing and population health? please discuss 2-3 aspects of poor quality data. Include 1 citation from your own experience and research.

Answer 1

Ans) The ICD is the global health information standard for mortality and morbidity statistics. ICD is increasingly used in clinical care and research to define diseases and study disease patterns, as well as manage health care, monitor outcomes and allocate resources.

- Current Procedural Terminology (CPT) is a medical code set that is used to report medical, surgical, and diagnostic procedures and services to entities such as physicians, health insurance companies and accreditation organizations. CPT codes are used in conjunction with ICD-9-CM or ICD-10-CMbnumerical diagnostic coding during the electronic medical billing process.

- A Current Procedures Terminology (CPT) codeis a procedure such as an ABR or reflex testing. The International Statistical Classification of Diseases and Related Health Problems (usually abbreviated as ICD) is in its 9th revision. The ICD-9 is a diagnostic code such as 388.30 for tinnitus, unspecified.

Meicaid - Children & women
Medicare 65 and older

- Accurate medical coding is necessary if expect to obtain insurance reimbursement. It's also important to maintaining the records of patients. Over coding happens when you report medical codes that actually result in a higher payment being made by the insurance company.

- The quality of accurate coding is critical in today's health climate. Coding is utilized for appropriate patient treatment, reimbursement, research, the basis of financial and clinical decision making and worldwide comparative trending. DRG accuracy of 95% and overall coding accuracy of 90% are both essential.