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Hospitals flip the ICD-10 switch, adding 68,000 ways to tell you're sick

Lucas Mearian | Oct. 2, 2015
The medical classification code goes live today.

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Credit: Creative Common Lic.

Linda Reed, the CIO at Atlantic Health, one of the largest nonprofit health care systems in New Jersey, is hoping today's changeover to the new ICD-10 medical coding system will be like Y2K -- all build up, no catastrophe.

"We know there will be issues. We're thinking we'll see them next week," Reed said, referring to when insurance companies will begin approving or denying medical treatments based on the new codes. "There are just so many moving parts."

After two major deadline extensions, the new, vastly expanded ICD-10 medical classification list went live today, affecting every U.S. healthcare provider and insurance company.

The diagnostic list contained in ICD-10, which increases the number of descriptive codes from 14,000 in ICD-9 to 68,000, forced facilities to upgrade and expand databases, add data storage and memory and increase staff.

The expanded codes cover descriptions for diseases, symptoms, abnormal findings, patient complaints, causes of injury or diseases and even social circumstances.

Some of the diagnostic codes can be archaic or absurd. Code Z63.1, for example, describes "Problems in relationship with in-laws," and code V97.33XD covers patients who were "sucked into a jet engine."

The codes, however, offer a far more accurate way to describe old and new diagnoses, diseases and medical procedures. In fact, the U.S. is vastly behind the curve in deploying ICD-10, a list created by the World Health Organization in 1993. The Czech Republic adopted it in 1994. Canada rolled it out in 2001. China adopted it in 2002.

"Other countries are starting to look at ICD-11 at this point," said Matthew Winestock, a spokesman for the College of Healthcare Information Management Executives (CHIME).

The new ICD-10 codes will dictate how the more than $2.8 trillion that Americans spend each year on medical care is paid out.

In August, a survey by the nonprofit Work Group for Electronic Data Exchange revealed that 90% of hospital respondents believed they were ready for the Oct. 1 transition.

"Anecdotally, what we hear is hospitals and their CIOs feel they're ready," Winestock said.

Hospitals, physician practices and other care facilities have been forced to add both full time and temporary personnel to ensure the correct codes are applied so insurance companies can appropriately bill for treatment.

Atlantic Health contracted a third-party company to help add the new codes to physician diagnosis and treatment and prescription orders.

Healthcare facilities have upgraded and expanded databases, and increased data storage systems and computer memory. There are separate inpatient and outpatient billing systems and ancillary billing systems used by individual departments, from radiology and labs to pharmacies that all must reflect the new ICD-10 coding system. Electronic medical records (EMRs) must be ICD-10 compliant as well.


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