Oct. 1 will be the day when doctors and hospitals across the country have to begin using a new medical coding system to describe visits of patients on insurance claims in order to get paid.
Health providers in the U.S. currently use a system of about 14,000 codes to designate diagnoses for medical databases and for reimbursement purposes. The new system, which is basically an expanded dictionary to store more details from the chart of the patient, will have nearly 68,000 codes.
The government says that the updated system should help health authorities better track the quality of care given to patients, identify early warning signs that indicate a brewing outbreak and search for injury and illness trends.
The 10th edition of the International Classification of Diseases (ICD) has codes that flag Ebola and novel strains of flu. The codes can also show how long sports concussion patients lost consciousness and if these patients require repeat care.
"ICD-10 has the potential to create many improvements in our public health system," said Centers for Medicare and Medicaid Services acting administrator Andy Slavitt.
Most industrialized countries have already switched to ICD-10 several years ago and the U.S. has the final compliance date on the first day of October.
Matt Martin, from the New Hanover Regional Medical Center, explained the necessity for the transition. He said that ICD-9 has obsolete and outdated terms and is already inconsistent with current medical practices.
American Academy of Family Physicians president Robert Wergin said that more precise diagnosis could help researchers and health providers have a closer look at trends.
The transition to ICD-10 from ICD-9, which was implemented in 1979 is a requirement for everyone covered by the Health Insurance Portability Accountability Act (HIPAA).
With the deadline fast approaching health providers were urged to ensure that their offices are ready. CMS chief of staff Mandy Cohen said that while CMS cannot estimate the number of health providers that are ready for the transition, officials think that most of the big practices and hospitals are already prepared so the agency focuses on smaller doctors' offices.
Private insurers, which told Congress a few months back that they are already prepared for the switch, also focus on small providers.
The CMS acknowledged that there could be problems during the initial period of the implementation so in response to concerns from physicians, the agency said it will provide some flexibility in the first year of assessing claims.
Photo: Jfcherry | Flickr
