Medical code descriptions expanding to 140,000 entries

The system of codes doctors and hospitals use to describe the ways they treat patients is about to go from 18,000 entries to about 140,000.

A new federally mandated version of the International Classification of Disease coding system will allow health care providers to more specifically indicate where and how injuries occur.

Billing experts who translate doctor's notes into codes are gearing up for the new system, which goes into effect Oct. 1, 2013.

It includes such codes as "bit by a duck." In fact, there are 72 codes about injuries tied to birds. Some of the codes could be viewed as insulting, such as "very low level of personal hygiene." Some make one wonder how that type of injury could even occur, such as "burn due to water skis on fire."

There are also multiple codes for the same injury, such as, walked into a lamppost, initial encounter: W2202XA; and walked into a lamppost, subsequent encounter: W2202XD.

Local hospitals say the new coding system, known as ICD-10, will help medical records coders to capture and provide more detailed information about patients and the care they receive.

Currently, there is one code for suturing an artery; under ICD-10, there will be 195 codes to indicate every single artery and other variables in the procedure.

The code used now, ICD-9, was developed in the 1970s and no longer serves the needs of today's health care system, said Aaron Spratt, American Recovery and Reinvestment Act director at Saint Francis Medical Center. It's his job to ensure the hospital complies with new health care reform laws.

However, the switch to ICD-10 has been planned since 2009, before the passage of federal health care reform in March 2010.

"The vast majority of the industrialized nations in the world converted to the ICD-10 system years ago," said Hugh King, SoutheastHEALTH vice president and chief financial officer. England converted in 1995, Sweden in 1997, Australia in 1998 and Canada in 2000.

"It's difficult to say why hospitals in the United States seem to lag behind these other industrialized countries in their ability to deal with coding issues," King said. "However, SoutheastHEALTH is confident that if the physicians and medical record coders in French Guiana can handle ICD-10, so can physicians and medical records coders in Missouri."

The ICD-10 system is vastly different from its predecessor, so even experienced coders and physicians will have a steep learning curve, Spratt said.

The process of converting to the new coding system will be expensive, too.

It will also require costly upgrades to existing computer systems as well as training for staff.

"Physician and staff productivity will suffer in the short term, and even after full adoption may not return to previous levels due to the increased time necessary to document more specific clinical information," Spratt said.

King compared the transition to going from using a rotary phone to a mobile smartphone.

Both hospitals say they're training physicians and medical records personnel to be ready for the new system to be implemented in 2013.

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ANSWERS

1. Struck by football

American footballs floating in air (studio shot)

2. Burn on left shoulder

3. Bitten by a turtle

4. Struck by a duck

5. Injured by a chicken coop

6. Walked into a lamppost

7. Struck by a golf club

8. Injured by crocheting

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mmiller@semissourian.com

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