Health care industry readies for massive medical code update

ICD-10 five little characters and a hyphen that are causing a whole host of headaches for medical providers and health systems across the country.

Come October after several years of delays hospitals, medical providers, insurers and medical coders will have to have transitioned to an updated version of the International Classification of Diseases (ICD) moving from the ICD-9 code sets to ICD-10.

These codes help physicians and hospitals communicate with insurers, allowing providers to explain services and justify claims.

ICD-9 has been in place for more than 30 years, and health industry experts say it is out-of date. The new codes will allow for greater specificity of reporting, which will help hospitals and insurers collect better data and pinpoint areas in which improvement is needed, including readmission rates.

We're running out of space to expand code sets, said Kim Vegter, a coding educator at MediRevv. The revenue cycle management company based in Coralville offers coding and billing services, working with health systems and providers across the country.

For instance a few years back, when H1N1 (swine flu) was popping up, the codes we had didn't clearly define H1N1. We need room to add codes so we can properly document, she said.

Because of this, Vegter said those in the medical industry may use unspecified codes, which don't provide specific details and could cause problems when it comes to justifying a claim to an insurer.

"The more specific we can be as to why, the better chance those services will get paid by the insurance company, which needs as much information as possible.

- Kim Vegter

MediRevv coding educator

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Health care industry readies for massive medical code update

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