Health Team

New coding system means more red tape for doctors, insurers

Posted October 1, 2015
Updated October 2, 2015

— Patients may or may not notice a major change occurring Thursday with healthcare providers and insurers. The United States is finally adopting a new and more complex medical coding system that’s been used worldwide for many years.

The new coding system is called ICD-10 and it replaces ICD-9, which healthcare providers have used for many years. The new system increases diagnostic identification from about 14,000 codes to 70,000. For procedures, codes increase from around 4,000 to 72,000. That means a lot more red tape for providers and insurers, and possibly some inconvenience for patients.

“We anticipate it will slow things down for several months,” said Vice President of health information utilization management for WakeMed, Becky Andrews.

Andrews said that delays are inevitable with such major change in how healthcare providers identify different diagnoses and procedures in their coding process.

She said that not only will the new ICD-10 system delay payments from insurers to providers, but patients may also be affected.

“Patient services will be covered, but it just may take longer to process to get a full settlement of their claim,” said Andrews.

The benefits of ICD-10 coding involve more detailed information about the health of the American population. It will help researchers gather more specific data for statistical analysis of disease and injuries.

Andrews said that patients may not notice a difference, at least early on.

“They shouldn’t notice it today. It will probably not improve care today. What it may do is improve care in the future,” Andrews said.

Due to the implementation of ICD-10, Thursday was a hectic day not only for hospitals but also in doctors’ offices.

The transition requires doctors to be a lot more specific about describing diagnoses. For example, for a knee sprain under ICD-9 was classified as a “sprain of an unspecified body part.” Under ICD-10, it would be classified as a “sprain of anterior ligament of left knee-initial encounter.”

Andrews said they expect delays in cash flow into January as payments and claims processing returns to normal.

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  • Nicolle Leney Oct 2, 2015
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    The original deadline of 2011 has already been pushed back like 4 times. Yes, it causes delays, etc when the system is finally put in place, but the article makes it sound like this isn't something that they have known about (and I'm assuming preparing for) for years.