October 1 is kind of a big deal

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A close friend recently suggested that I try to learn a new language.  The thought wasn’t very appealing to me until I realized that all of health care will be speaking a new language on October 1, 2015.

That’s the day when the nation’s health care providers must start using a massive new coding system to describe your visit, test and/or treatment on insurance claims so they get paid.  The new language is ICD-10 and for providers the change is like learning a new language.  The comparison to a language fits because a language is made up of a set of words, and providers are expanding their language from 14,000 words to 68,000 words. It’s a big deal.

Today, health providers use a system of roughly 14,000 codes to designate a diagnosis, for reimbursement purposes and in medical databases. To get more precise, the updated system has about 68,000 codes, essentially an expanded dictionary to capture more of the details from a patient’s chart.

How precise? Get nipped feeding a bird, and the codes can distinguish if it was a goose or a parrot. Have a bike accident with one of those horse-drawn tourist carriages? Yep, there’s a code for that, too.

Unusual accidents aside, the updated code set should help health officials better track quality of care, spot early warning signs of a brewing outbreak or look for illness or injury trends.

Under ICD-10 — the 10th edition of the International Classification of Diseases — there are codes that flag novel strains of flu, for example, and even Ebola and its cousins. With increasing focus on sports concussions, the codes can reflect how long patients lost consciousness and if they needed repeat care.

Why are codes so important? Most medical records are digital and more precise diagnosis codes could allow researchers, even doctors themselves, to get a closer look at trends in one office or the entire country. A search of an office’s data could show how, say, all pregnant women with a urinary tract infection in the third trimester fared.  If we look outside the office, the codes will help to better compare medical care and treatment provided in the United States to that of other industrialized countries.  The US is late to the party and other countries have been on ICD-10 for years.

The go live date for ICD-10 is October 1, 2015.  That’s the day everything changes but the date shouldn’t take anyone by surprise.  The conversation to ICD-10 was originally supposed to happen on October 1, 2014, but it was delayed because many providers weren’t ready.  GVMH has been preparing for the conversion for more than two years, we were ready last year at this time but the delay has provided us more time to identify any potential road bumps.

I’m not saying the transition will be easy but I’m confident we are as ready as any organization in the country but because not all other providers or insurance companies are as prepared, we will feel some effect.

So October 1, 2015, is a big deal and I appreciate your understanding if we get a little tongue-tied trying to speak our new language.

About Craig Thompson

I am a young professional with two great sons, and I work in the healthcare setting. I am employed in hospital administration and serve as Chief Operating Officer at Golden Valley Memorial Healthcare in Clinton, Missouri. These are challenging and exciting times in healthcare and my blog will focus on healthcare, raising boys or being raised by boys, and living in mid America.
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