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You are here: Home / Health / New Coding and Billing System ICD 10 Raises Problems

New Coding and Billing System ICD 10 Raises Problems

October 5, 2015 By Janice Bower 1 Comment

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With the introduction of Obamacare in 2014, it was announced that a new medical coding and billing system will be duly set in place. Here it is, the ICD 10.

With the introduction of Obamacare in 2014, it was announced that a new medical coding and billing system will be duly set in place. Here it is, the ICD 10.

With the introduction of Obamacare in 2014, it was announced that a new medical coding and billing system will be duly set in place. Here it is, the ICD 10.

The new International Classification for Disease (ICD), the implementation of which started with October 1st, comes as a much-needed revision of the ICD 9, standing as the reference medical coding and billing system since 1978. The efforts to redefine the ICD have been ongoing for years.

Now, they have been sent out to healthcare providers and insurance companies across the U.S. The ICD 10 is a peculiar new coding system that leaves many wary of its implementation, albeit the noticeable benefits it brings about.

Medical providers are swamped in implementing the newly designed codes, the number of which increased considerably. Insurance companies complain of a similar situation. Patients worry about their medical bills going higher, as well as an exponential increase in the time needed until they receive medical care or are able to submit their insurance claims.

To unwind for a while, consider a few of the new codes that must be filled accordingly by medical practitioners and insurers alike. We now have a specific code that pinpoints a ‘burn due to water skis on fire’. This is code V91.07XA. We also have the code Z63.1 which, scribbled in one’s medical record designated ‘problems in the relationship with in-laws’.

Back to more serious concerns, the ICD 10, albeit in its first few days of implementation, is causing havoc for many healthcare providers across the U.S. The ICD 10 requires a strict, very specific and lengthy coding procedure that needs to reflect the billing purposes as well. There are over 140,000 new codes included in the ICD 10, of which codes that identify injuries or diseases represent 70,000. Many are asking if the change was necessary.

According to the Health Information Management officials, the timing couldn’t be better. Since 1978, a number of new diseases and new treatments have been left uncoded. As such, the ICD 10 is nothing but a helpful tool to ease the workload once everyone gets on board and accustomed to the new coding and billing system.

According to Chris Miles, the senior VP of Aon Hewitt health group:

“Transferring to the new medical claim codes will allow key industry stakeholders to better track and manage diseases, measure the quality of care and evaluate patient outcomes – all of which support the shift toward value-based payment plans”.

However, Doctor Halee Fischer-Wright, who is the president and CEO of the Medical Group Management Association worries that the implementation of the ICD 10 has caught many unprepared. The results of one survey indicates that over 20 percent of medical offices aren’t informed about the updates in view of billing purposes.

This could turn into serious added pressure on patients’ insurance claims. Private insurance companies are also unaccustomed to the ICD 10. When processing patients’ claims, all paperwork must coincide with that from the healthcare provider.

Currently, insurance companies such as Humana, UnitedHealth Group, Cigna, Aetna or Anthem have reported extra expenditures in view of alignment with the new medical coding and billing system.

Photo Credits: Flickr

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Filed Under: Health Tagged With: coding and billing system, healthcare providers, ICD 10, insurance companies, patients

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