Students currently enrolled in medical coding classes know how this vital component to billing patients is a constantly changing infrastructure within our health care system. In addition to serving as the basis for evaluating health-related payments, converting all the codes that correspond to their respected supplies and drugs is also an essential aspect to analyzing patient treatment records or other types of valuable insurance information. There has already been a proposed and accepted update by the American Medical Association that a change in the guard for medical coding will take place in late 20151. Here’s what anyone involved in medical coding training should know about the upcoming updates:
ICD-9 to ICD-10
The latest regulations of the International Classification of Diseases (ICD) will shift from its ninth revision to a new, 10th edition, set to officially take place on October 1, according to the American Medical Association. This will mark the formal transition from the ICD-9 classification to the ICD-10 version. There was a one year delay in this passage of revisions, largely due to the implementation of the Protecting Access to Medicare Act of 2014, which was an amendment to the Social Security Act in reference to revising certain forms of Medicare payments. The ICD-9 will remain intact until Sept. 30 of this year, when the official transition to ICD-10 will officially be applied.
The primary objective of this update is to help enhance communication for physicians and hospitals with insurance providers in terms of justifying various claims and services. ICD-9 had been in place for more than 30 years, and the call for a replacement guideline was a response to addressing the need to improve data collection for patients. The most apparent change that will take place will be the expansion of codes, which will increase from 13,000 to about 70,000. While the addition of so many codes sounds intimidating, many of the codes will serve as a means for signaling a combination of symptoms and diagnosis, which in turn will simplify condition description for coders.
Leading up to the proposed transition date, Medicare will plan to test out the latest ICD-10 codes with a variety of health care providers, in an attempt to practice how this new procedure of processing claims will change over. This “trial” period will aim to help get physicians more used to the transformation over to the ICD-10 codes, as well as hopefully provide better information to health care providers on how claims will be processed and paid through Medicare with these new codes.
Prepare for obstacles
As with any big medical industry transition, experts are predicting that there will be a few obstacles to look out for during this transformation phase of switching over to ICD-10. Coders should be on the look out for potential billing and coding software glitches that could arise, due to operating systems not recognizing the newer codes. AMA president-elect Dr. Steven J. Stack expressed how the organization acknowledges that the initial transition period may be a bumpy one for adjusting to the latest codes.
“While the AMA appreciates that physicians have additional time to comply with ICD-10, we continue to have fundamental concerns about ICD-10 and its implementation, which will not be resolved by the extra time,” Stack said in a press release. “The AMA has long considered ICD-10 to be a massive unfunded mandate that comes at a time when physicians are trying to meet several other federal technology requirements and risk penalties if they fail to do so.”
Even though the beginning stages of ICD-10 code regulation may be rocky, health care providers remain optimistic that the new system will eventually be the more reliable and efficient system of codes to accompany the current state of health care.
2 “What Is Medical Billing and Coding?” Medical Billing Career, March 29, 2012, http://www.medicalbillingcareer.org/medical-billing-coding/
3 “What is Medical Coding?” American Academy of Professional Coders, https://www.aapc.com/medical-coding/medical-coding.aspx