Come the first week of October next year, the number of codes to document, say, an angioplasty will go from one to 854. The number of pressure ulcer codes will jump from nine to 125. Asthma will need to be classified as “mild,” “mild intermittent,” “mild persistent,” “moderate persistent,” or “severe.”
Yes, this week brought the opening of the Affordable Care Act’s health insurance exchanges, but Oct. 1, 2014 will usher in another revolution for physician offices: the International Classification of Diseases, version 10 — ICD-10.
And the date is one that the Centers for Medicare and Medicaid Services has stood firm on after granting a 1-year delay.
The much-dreaded update to the coding system that determines how much physicians will be paid increases the number of procedure and diagnostic codes from roughly 17,000 to nearly 150,000 and requires much greater detail on location of ailments, cause and type, and complications or manifestations compared with ICD-9.
While ICD-9 codes are three to five numbers long, ICD-10 codes are up to seven digits long and include numbers and letters.
And reimbursement will depend on getting them all right.
Several health information technology experts advise physician offices to start testing systems and workflow practices now — if they haven’t already — to prepare for the transition.
Deepak Sadagopan, general manager of clinical solutions at the Bellevue, Wash., health IT company Edifecs, said providers should expect multiple disruptions to offices, involving reimbursement, contracts with payers, and worker productivity.
“There are multiple impacts that could potentially ripple through the organization,” Sadagopan said on a webinar Tuesday. “Some of these impacts are going to be with your organizations for some time.”
A computer-assisted coding system may help smooth workflow, he said. But Sadagopan said providers also must improve the specificity of documentation in order to meet ICD-10’s increased billing demands.
Nearly two-thirds of clinical documentation doesn’t contain enough information for coders to use for billing under ICD-10, according to a survey from AAPC, a medical coding society based in Salt Lake City, Utah.
AAPC gives a number of tips for physicians:
