![]() ![]() Professionals requesting ICD-10 codes from hospital case managers and call centres Furthermore, proper documentation of patient health records, which must be available to all clinical staff involved in the treatment of a patient, is a legal requirement as per the Health Professionals Act no. Recording of clinical informationĬlinical documentation at hospitals is often insufficient for accurate coding, resulting in the assignment of sign and symptom codes and over-utilisation of default codes, which impacts negatively on health data collection and incorrect payment of benefits.Īs per the National Health Act (NHA), all medical practitioners are required to complete the discharge summary which reflects the patient’s diagnoses, treatments and health education provided on discharge. ![]() Industry Table (MIT) as Valid_ICD-10_Clinical Use and Valid_ICD-10_Primary. Any healthcare professional who renders a service within his/her scope of practice may use any of the clinically correct ICD-10 code(s) indicated on the 2014 ICD-10 Master No ICD-10 code may be allocated or ‘reserved’ for a specific healthcare discipline or practice. ![]() Some medical schemes informed certain healthcare professionals that some ICD-10 codes are reserved for use on accounts by specific practice types and may thus not be used by other professionals. The CMS has noticed that healthcare professionals experience challenges in coding, and advise on the following areas of concern.Īllocation of certain ICD-10 codes to specific disciplines The Council for Medical Schemes (CMS) is a statutory body providing regulatory supervision of private health financing through medical schemes. ICD-10 codes are used to inform medical schemes about what conditions their members were treated for by healthcare practitioner so that claims can be settled correctly. ![]()
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