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AMA wants protection for doctors rolling out new medical coding system

Lucas Mearian | June 11, 2015
The ICD-10 coding system affects dozens of core applications for healthcare providers and insurance payers.

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The changeover from using 14,000 ICD-9 codes to 68,000 ICD-10 codes will affect every healthcare billing system, from inpatient and outpatient to radiology and pharmacy.

The American Medical Association (AMA) today voted in favor of a two-year grace period to protect hospitals and physician practices that implement a new medical classification system.

The vote related to the federally mandated ICD-10 coding system is mostly symbolic, as the AMA doesn't make federal policy.

The AMA's House of Delegates, however, does represent U.S. doctors, medical students and residents and is working to create a national physician consensus on emerging issues in public health.

ICD-10, which is designed to better track diagnoses and treatments, affects dozens of core applications for healthcare providers and insurance payers. Currently, there's an Oct. 1, 2015 deadline for implementing the new medical coding system.

While the AMA has voted in favor of delays, conversely, healthcare CIOs and other senior IT leaders have expressed concerns about deadlines being extended.

The College of Healthcare Information Management Executives (CHIME) has stated that every day that passes without a concrete deadline "is another day that should have been spent planning and implementing this critical undertaking."

To date, ICD-10, a medical coding system developed and used by the World Health Organization (WHO), changes out about 15,000 codes used in ICD-9 for approximately 68,000 new ones.

For example, when ICD-9 was rolled out in 1978, there was no such procedure as arthroscopy, where an endoscope is used to perform minimally invasive surgery on a joint. ICD-10 codes also add whether a procedure is an initial one or a subsequent treatment.

The new codes are also vastly more descriptive.

If a physician is treating a broken ankle, the ICD-10 code needs to be selected for which leg the ankle is on, whether it's on the lateral or medial side and whether the injury is an open or closed fracture.

At times, the detail with which ICD-10's codes describe medical conditions can  wander into the bizarre. For example, if you were stabbed while crocheting, your doctor would use the code Y93D1. Sucked into a jet engine? That's a V97.33XD.

There's even a code for having been attacked by a squirrel.

The codes, however are serious business and will dictate how the more than $2.8 trillion that Americans spend each year on medical care is paid out.

The new coding system is so complex that the mandate requiring it has been delayed twice. As its current deadline approaches, there are industry rumblings that it may be delayed again.

 

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