New medical coding system set to take effect

Associated Press

WASHINGTON

If things are a bit tense in your doctor’s office come Oct. 1, some behind-the-scenes red tape could be to blame.

That’s the day when the nation’s physicians and hospitals must start using a massive new coding system to describe your visit on insurance claims so they get paid.

Today, U.S. health providers use a system of roughly 14,000 codes to designate a diagnosis, for reimbursement purposes and in medical databases. To get more precise, the updated system has about 68,000 codes, essentially an expanded dictionary to capture more of the details from a patient’s chart.

How precise? Get nipped feeding a bird, and the codes can distinguish if it was a goose or a parrot. Have a bike accident with one of those horse-drawn tourist carriages? Yep, there’s a code for that, too.

Unusual accidents aside, the government says the long-awaited change should help health officials better track quality of care, spot early warning signs of a brewing outbreak or look for illness or injury trends.

Under ICD-10 – the 10th edition of the International Classification of Diseases – there are codes that flag novel strains of flu, for example, and even Ebola and its cousins. With increasing focus on sports concussions, the codes can reflect how long patients lost consciousness and if they needed repeat care.

“ICD-10 has the potential to create many improvements in our public health system,” Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services, told health providers in a recent conference call.

But with the deadline approaching fast, he urged providers to make sure their offices are ready, and that they take advantage of Medicare-offered testing that lets whoever handles their billing file practice claims.

Might patients see an uptick in insurance denials for coding errors that require the doctor’s office to refile the claims? Dr. Robert Wergin, president of the American Academy of Family Physicians, is optimistic that providers are ready enough that patients shouldn’t feel an impact.

“Sitting in the room with a patient, I don’t think you’ll notice anything,” Wergin said.

His 10-doctor practice in rural Milford, Neb., has updated the electronic medical records of patients with chronic diseases, so the next time the diabetic with early kidney disease comes in, that new code is one less thing to check.

Most doctors’ offices only use several dozen codes anyway, to match each specialty’s typical diagnoses, Wergin noted. “Really, I probably live in a world of 140 codes.”