Friday, October 2, 2015

There’s a Code for That

waterskisicd_1024x1024

Beginning this month, the government will require doctors, hospitals and health insurers to begin using a new set of codes.  Known as ICD10, it is a new, and vastly more complicated, set of codes to describe injuries and illnesses. 

The old codes – ICD-9 – had not been updated in 36 years, and many were no longer valid.  The new codes try to be more specific, and as a result, the codes doctors now must use to diagnose patients have multiplied from about 14,000 to nearly 70,000. Hospitals use a related set of medical procedure codes, which has grown even more — from 4,000 to about 72,000.

Specificity may be a good thing, but some of the codes are just bizarre:

  • W61.33 pecked by a chicken
  • Y08.01 assault by hockey stick
  • R46.1 bizarre personal appearance
  • W22.02XD walked into a lamppost
  • T71.224 asphyxiation due to being trapped in a car trunk
  • Z63.1 problems in relationship with in-laws
  • V95.42 forced landing of spacecraft injuring occupant
  • W61.12xA struck by macaw, initial
  • The water-skis on fire code at the top of this post is real.  The picture is from an illustrated book titled Struck By Orca which is available on Amazon.

    The changeover won’t come cheap.  In just one example, Kaiser Permanente's 4 million-member health care region in Southern California, the transition involved revamping up to 30 computer systems and training about 10,000 employees, at an estimated cost of $15 million to $25 million.

    While health organizations in the United States have long been preparing for the transition from ICD-9, the actual changeover date was delayed several times after some physicians and provider lobbying groups said they weren't ready.

    Even with the additional time, some recent tests of the codes among early adopters nationwide resulted in about a fifth of the claims being denied because they weren't accurate or weren't correctly submitted. I can’t say for sure, but there’s probably a code for that.

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