New Medical Coding System To Be Implemented In The Fall

Aug. 19--Under a new medical coding system scheduled to roll out in the fall, a roller-skating injury isn't as simple as it sounds.

Did the roller-skater collide with a car, pickup truck, nonmotor vehicle, pedal cycle, van, bus, heavy transport vehicle or a train or vehicle? Was it a traffic or nontraffic incident?

Was the person wearing in-line or non-in-line roller skates when he or she fell? Or did they collide with a stationary object?

In less than two months, the new coding system to classify medical diagnoses and procedure coding is scheduled to (finally) replace a decades-old set of codes and offer some rather specific ways to categorize injuries and conditions.

Most industrialized countries moved to the new International Classification of Diseases, 10th Edition (ICD-10) several years ago, according to the Centers for Medicare and Medicaid Services. The U.S. has a final compliance date of Oct. 1. The transition from ICD-9, which was implemented in 1979, is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA), according to CMS.

ICD-9 has "outdated and obsolete terms, and is inconsistent with current medical practices," said Matt Martin, New Hanover Regional Medical Center's interim director of business applications for the information systems department.

Thaddeus Dunn, NHRMC's chief medical information officer, said although ICD-10 represents a "significant change" in the documentation of patient care, it "will not impede clinical treatment of patients." Dunn acknowledged some anticipated delays in scheduling for elective procedures, but these will be adjusted as the community moves toward full compliance.

The new coding system, which includes an additional 55,000 codes, allows for greater specificity and exactness in describing a patient's diagnoses and classifying inpatient procedures, Martin said.

There are at least 20 different pieces of sporting equipment listed in ICD-10 that a person could be struck with. And a hockey stick isn't specific enough. (Field or ice hockey?)

Carla Turner, personal health services manager at New Hanover County Health Department, said the distinct codes help paint a better picture of what's going on with the patient, and therefore can help providers give better care.

In addition to helping doctors with patients' continuum of care, the added specificity ICD-10 provides can help insurance companies determine responsibility for costs, said Alysa Bostick, spokeswoman for Wilmington Health. For example, the code for an entangled parachutist could mean the insurance company would consider an entity that rented parachutes responsible.

NHRMC tested its completed system and Martin said "that has all gone smoothly."

The health department was part of a pilot program to test submitting claims with ICD-10 codes, which Turner said was successful.

Contact Lydia Coutre at 910-343-2223 or [email protected].

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