A New Era

Today is the last day that the antiquated ICD-9 diagnosis coding system will be used in medical practices and hospitals across the country. As of tomorrow, medical billers will be required to use the newer (to this country) ICD-10 system, which is already used in the rest of the civilized world. Coders, billers, and most other medical professionals have invested a lot of time preparing for this day.

There was training to be done and subsequent testing and finally certification of the coders. Then the computer systems in every medical practice had to be upgraded with the new information, and oh yes, be tested for HIPPA compliance. And, as one of our blogging friends reminded us on several occasions, medical notes themselves needed to be updated with the new codes. Surely this was a long, arduous task and one that I seriously doubt could be billed to any insurance carrier. This meant that many medical professionals would have to revise their notes on THEIR time.

Oh, the horror of it all!

I’m not belittling their efforts by any means. You just need to compare one diagnosis to see the difference in the two systems to realize the amount of work that needed to be done.

Let’s take diabetes mellitus. The ICD-9 system uses a maximum of five digits. The very basic code for diabetes is 250.0, but this doesn’t account for the over 200 diabetes related conditions and their corresponding codes. In most of these cases, this requires the addition of a fourth digit to further describe the complication and the fifth digit to describe if the condition is either type one or type two.

ICD-10 lists diabetes mellitus as E10. Yes, this is an actual code and not a peg hole on your Battleship game.

Unfortunately, all of the codes in the new system are not this simple. ICD-10 is more precise in its descriptions of the condition, its location (body part or organ) and even the stage of treatment for the condition (new or subsequent visit). Location of the condition is trickier in ICD-10. The old system merely differentiated between right and left side of the body or organ. The new system, for example, divides one organ, the heart, into quadrants: upper left, upper right, lower left, lower right. All this precision means more codes and the possibility of more digits (up to seven) in each code.

Anyway, my point today is not to bore everyone with endless coding examples, because it is time to party! It’s the end of an era and time to usher in the new era a la New Year’s Day! Out with the old, in with the new! A time for toasts at midnight, frivolous conviviality, and especially an excuse to imbibe in nasty chips and nasty chip dip!

Woo-hoo!

Oh, who the hell am I kidding. I’ll be in bed by 8:30p. Besides, as far as I know, the AMA is not planning any special events. No party, no orchestra, not even dropping a ball made entirely of used rubber gloves at midnight. 

Hrumph! Some celebration! Another hrumph!

Who planned this transition in the middle of the year, in the middle of a work week, anyway? Oh, that’s right, the killjoys in Congress. No surprise here!

(Thank you for reading. Happy New Coding, Spo!)