Saturday, February 11, 2012

Burned while waterskiing? There's a code for that...

When I see a patient in clinic or the hospital, I have to write down what problems he/she is having so that an appropriate bill can be generated for my services. It should be no surprise that there is a series of codes that one must select from, so that we can all agree that if I see a patient for 786.5, we all know that is "chest pain". The system is called the "International Statistical Classification of Diseases and Related Health Problems" and is presently in the 9th revision.We have used the 9th revision for many years now, and the federal government and insurers want to move on to the next iteration.

This older article from the Wall Street Journal just got forwarded in email to me, and helps provide some perspective about the 10th revision. As a top line overview, the system goes from 18,000 codes in ICD-9 to 140,000 codes in ICD-10. That means that not only do doctors and coders have 10 times as many choices to select when describing a patient's conditions, but all of the software for all of the electronic medical records systems, billing and coding systems, etc. have to be retooled to think in ICD-10. I am no computer programmer, but visions of the Y2K bug are flashing before me.

What do doctors and patients get out of this 10-fold expansion of codes? Well, finally, I have a code for coding "burn due to water-skis on fire". Thank goodness! For the surgeons out there, they now have not just one, measly code for saying they stitched up an artery, but 195, one for every artery they could think of and several other variables as well!

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