Healthcare Coding: ICD-10 Application and Health Insurance Needs

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This assignment provides a detailed overview of healthcare coding, focusing on the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and its significance in health insurance. It discusses the use of ICD-10 codes, specifically for benign neoplasms, and elaborates on the experience of using the manual system for disease coding. The assignment highlights the necessity of accurate coding for statistical tracking, communication between stakeholders (insurance companies, patients, and healthcare providers), and efficient healthcare operations. It also emphasizes the role of medical coding in facilitating insurance reimbursement and ensuring complete and accurate patient records, concluding that medical coding expedites healthcare payments and aids in administrative operations and symptom identification. Desklib provides a platform to access similar solved assignments and study resources.
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Running head: HEALTHCARE
Coding and health insurance
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Introduction- The International Statistical Classification of Diseases and Related
Health Problems or ICD-10 is the 10th revision of the medical classification list that is
commonly formulated by the World Health Organization (WHO, 2018). It contains codes for
a plethora of signs and symptoms, complaints, abnormal findings, diseases, external cause of
disease or injury, and social circumstances. This assignment will elaborate on the need of
disease coding, in relation to the domain of health insurance.
Discussion- The basic classification of ICD contains information on an estimated
14,000 dissimilar quotes that help in tracking new disease by diagnosing them at any point of
time. Benign neoplasm has been selected as the topic of interest for coding. The condition
refers to a mass of localized tumor that grows slowly. Owing to the fact that benign neoplasm
does not have the characteristic of metastasis, or spreading to distant location, it is
particularly considered to be non-cancerous and some common forms of such neoplasm are
hemangioma, fibroma, adenoma and lipoma (Sun et al., 2015). The code for 10 ailments
selected for this assignment is given below:
Number Illness Code
1 Benign neoplasm of larynx D14.2
2 Benign neoplasm of bronchus and lung D14.3
3 Benign neoplasm of thymus D15.0
4 Benign neoplasm of heart D15.1
5 Benign neoplasm of Short bones of upper limb D16.1
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6 Benign neoplasm of Long bones of lower limb D16.2
7 Benign neoplasm of Vertebral column D16.6
8 Benign lipomatous neoplasm of skin and subcutaneous tissue of trunk D17.1
9 Benign lipomatous neoplasm of skin and subcutaneous tissue of limbs D17.2
10 Benign lipomatous neoplasm of intrathoracic organs D17.4
Table 1- ICD codes for 10 illnesses
(Source- Icd.who.int, 2016)
The experience of using the manual system of disease coding was quite easy, since
the presence of optional categorical divisions in the tool facilitated searching specific
information, regarding the manifestation, cause, severity, location, and type of disease. In
addition, presence of the alphanumeric structure also helped in preventing confusion between
the different categories of benign neoplasm that affect several reasons of the human body.
Accurate coding of disease is crucial for building and tracking statistical information
about a particular medical treatment and disease. It forms of vital connection between
insurance companies, patients, and healthcare providers, by enabling gaming adequate
information on the medical history, diagnosis, and treatment of the patient. The established
codes help in transcribing patient history and disease in shorthand that are used by insurance
companies, for providing them the necessary health coverage (Aalseth, 2014). Presence of
code ensures that patient records are complete and accurate. Need for accuracy in medical
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coding is imperative for patient safety, efficient healthcare operations, and rapid payment for
the services. Transferring the alphanumeric code from the source to a particular medical
billing system will help in submitting medical claims and bills with insurers for the patients,
thereby facilitating the process of insurance reimbursement (Johnson & Linker, 2015).
Conclusion- To conclude medical coding helps in expediting the payment of
healthcare amenities for the physicians, and also serves as a critical component of drawing
comparison between planning and projects for under-served health domains, thus assisting in
administrative operations and identification of symptoms by physicians.
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References
Aalseth, P. (2014). Medical coding. Jones & Bartlett Publishers.
Icd.who.int. (2016). International Statistical Classification of Diseases and Related Health
Problems 10th Revision (ICD-10)-WHO Version for 2016. Retrieved from
https://icd.who.int/browse10/2016/en#
Johnson, S. L., & Linker, R. (2015). Understanding medical coding: A comprehensive guide.
Cengage Learning.
Sun, B. L., Abern, M., Garzon, S., & Setty, S. (2015). Cystic nephroma/mixed epithelial
stromal tumor: a benign neoplasm with potential for recurrence. International journal
of surgical pathology, 23(3), 238-242.
World Health Organization. (2018). ICD Information Sheet. Retrieved from
https://www.who.int/classifications/icd/factsheet/en/
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