Delaying nonspecific code rejection has enabled inferior procedures to succeed, says the essay’s author. Undefined codes also fail to express the complexity of the individuals they serve appropriately. These codes appear to be regarded as undesirable and should be avoided at all costs. Unspecified codes are thought to have a negative impact on the reliability of data compiled using these codes (Selby, 2016). Many physicians’ paperwork supports a correct code, but they are not using it since they do not know how to.
When individuals believe ICD-10 might be useful, they must equally confront its downsides. An example of an undefined ICD-10-CM code is an inaccurate test-ordered diagnosis when a patient consults a gynecologist frequently and has symptoms comparable to ovarian cysts (Shehab et al., 2019). Ovarian cysts may be recognized for the remainder of a woman’s life if a clinician records the particular ICD-10 code before testing. Increased specificity may lead to more erroneous data being utilized. Another example is when coders who report a patient’s appropriate lobe excision instead of left lung lobe ectomy put themselves and their patients in danger. It influences what will happen if the patient’s left lung needs to be removed in the future. The insurance provider may refuse the claim owing to pre-existing illnesses of the patient.
However, coding experts must also give diagnostic codes to the degree of specificity set by physicians. Assume the following scenario, where the emergency room provider notes a non-displaced right talus fracture. The right ankle is non-displaced, and the right talus is avulsion fractured. Coding specialists must focus on the specificity of provider documentation. After an encounter, a coding professional should check the diagnostic codes to verify they are correct. Unspecified diagnostic codes, such as zero or nine, are prevalent. It may be essential to re-examine clinical data to get a more exact diagnosis code.
Shehab, N., Ziemba, R., Campbell, K. N., Geller, A. I., Moro, R. N., Gage, B. F., & Yang, T. H. (2019). Assessment of ICD‐10‐CM code assignment validity for case finding of outpatient anticoagulant‐related bleeding among Medicare beneficiaries. Pharmacoepidemiology and Drug Safety, 28(7), 951-964.
Selby, L. (2016). Are unspecified ICD-10 codes setting your practice up for a Titanic scenario? The DO. Web.