In major change, US adds thousands of medical codes

06 Oct 2015

A system of diagnostic codes forming part of an extensive overhaul at doctors' offices, hospitals, nursing homes, insurance companies and just about every part of the US health system, went into effect last week.

If things were to go according to the long-delayed plan, it would not affect patients and care.

However providers, who would be required to use the codes describing patients' illness and injuries to get paid, are preparing to face problems - the sweeping revision, over a decade in the making, would see the current nomenclature expand from about 14,000 codes to 68,000.

Physicians' offices, hospital systems and the federal government had spent billions of dollars on training to get ready for this transition.

According to detractors, however, it was too costly and not worth it.

Some experts are worried that coding errors could result in claims getting denied and delayed.

The updated designations, officially known as the 10th version of the International Classification of Diseases, or ICD-10, are aimed at helping faster identification or the warning signs of epidemics like Ebola or potential flu pandemics, by the health care system.

With the new codes, the accuracy of payments to providers is expected to improve. It is also expected to reduce fraud and assist researchers in better understanding and treating complex medical conditions.

For example, under the new system ''W21.31XA: Struck by shoe cleats, initial encounter,'' would be used if a person playing football were to be hit by an opponent, taking off one her shoes and hitting the patient.

The ICD-9 system had been in use in the US since 1979.

''Everything we do is documented - that is the patient record. The more meaningful the record, the better the care,'' said Marjorie Sisson, the ICD-10 administrator for Banner University Medicine at Tucson. ''ICD-10 requires more specificity,'' tucson.com reported.

The change could lead to the emergence of new trends not known earlier. For instance bicycle crashes with pedestrians, skateboard crashes with cars and injuries in all-terrain vehicles would be recorded in detail.

''I do think it is ultimately a good thing. It was not an easy thing to do, but it allows us as a nation to be able to share information with the World Health Organization using the same nomenclature,'' said Maria Persons, director of revenue cycle and the ICD-10 project lead at Tucson Medical Center.