Are You Ready for the Switch to ICD-10?

ICD-9 will soon be phased out making room for the new standard, ICD-10. The tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD) is set to be implemented in October after several delays.

The delays were caused by the major impact introducing the ICD-10 will bring on healthcare professionals. The new revision is far more specific than its predecessor, which requires over 4 times the number of codes. The sheer number of new codes will cause a steep learning curve for all current medical coders and any aspiring ones.

What medical coders do is they convert doctors’ handwritten scribbles into specific codes that are then sent to insurance companies. The insurance companies use the codes to decide what and how much to pay. One major advantage over the new set of codes is the ability to determine which side of the body the medical condition applies to.

This alone will greatly cut down on insurance fraud as insurance companies can now see more details. For example, a knee replacement on the right and left knees is more likely a real situation than repeated replacements of the same knee.

However, some opponents to the new set of standards argue the codes are too specific, offering now added value and just increasing the burden on the coders who must learn the new codes. For example, there is a code, W53.21, for a squirrel-induced injury, another one, V80.919, for an injury caused by a collision with a motor vehicle while riding an animal, and a code, W93.2, for spending too much time in a refrigerator.

There are also two different codes used for turkey bites. However, the additional codes do offer the ability to see health related patterns, like a sweeping flu season. In addition, the new codes also make it possible to keep track of first time hospital visits compares to repeated visits. Since the first visit usually costs more due to initial tests and x-rays, this can help insurance companies determine how much to pay.

The codes alone are not the only obstacle. New software and systems need to be put in place to handle all the new codes. For the greater part of a decade, hospitals, medical coders, and insurance companies were relying on the ICD-9. Some software and systems can be upgraded, but others have to be completely replaced.

Overall, the greater accuracy and visibility into the current health situations of the country as a whole should provide valuable insight to medical researchers.