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ICD-9 and CPT Diagnostic Codes

What kind of problems can ensue from inaccuracies in the assignment of ICD-9 and CPT codes? How do such inaccuracies affect patient care and reimbursement?

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RESPONSE:

1. What kind of problems can ensue from inaccuracies in the assignment of ICD-9 and CPT codes?

Let's get some definitions out of the way. On the World Health Organization (WHO) website, for example:

"The ICD is the international standard diagnostic classification for all general epidemiological, many health management purposes and clinical use. These include the analysis of the general health situation of population groups and monitoring of the incidence and prevalence of diseases and other health problems in relation to other variables such as the characteristics and circumstances of the individuals affected, reimbursement, resource allocation, quality and guidelines. It is used to classify diseases and other health problems recorded on many types of health and vital records including death certificates and health records. In addition to enabling the storage and retrieval of diagnostic information for clinical, epidemiological and quality purposes, these records also provide the basis for the compilation of national mortality and morbidity statistics by WHO Member States?(http://patients.about.com/gi/dynamic/offsite.htm?zi=1/XJ&sdn=patients&cdn=health&tm=6&f=20&su=p736.8.336.ip_&tt=2&bt=1&bts=1&zu=http%3A//www.who.int/classifications/icd/en/).

On the other hand, the CPT (Current Procedural Terminology) codes are numbers assigned to every task and service a medical practitioner may provide to a ...

Solution Summary

This solution examines the kind of problems that can ensue from inaccuracies in the assignment of ICD-9 and CPT diagnostic codes and how such inaccuracies affect patient care and reimbursement.

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