Sea change in medical coding draws scorn on the House floor

doctor-1As U.S. health care providers continue the march toward implementing the ICD-10 — a standardized set of medical diagnoses used by medical professionals across the world — the code set was lambasted on the floor of the House of Representatives earlier this week, The Hill reported.

Ted Poe, a Congressman from Texas, criticized the hyper-specificity of the code set, which evidently includes codes for people who have been injured by basketballs and turkeys — seriously — as well as codes for those who walk into a lamppost.

“Seems nine codes for a turkey assault is a bit silly,” Poe told The Hill.

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He went on to blast the “red tape” and “bureaucracy” being imposed on the nation’s health care providers.

What Poe failed to acknowledge, at least in The Hill report, was that providers rely on the code set not only to record patient diagnoses, but also to recoup reimbursement payments from private, commercial and federal payers.

Inaccurate code diagnoses result in rejection of claims, which cost providers and payers an average of $25 per rejection, according to the Healthcare Financial Management Association.

Nor did Poe mention the fact that the U.S. is almost 20 years behind the curve when it comes to upgrading from ICD-9.

The 10th edition of code updates was first endorsed in May 1990 by the 43rd World Health Assembly; World Health Organization Member States began implementing ICD-10 in 1994.

That isn’t to say that providers aren’t fretting the update.

According to a tip sheet from the American Medical Association, the volume of diagnosis code sets will increase from approximately 13,000 codes under ICD-9 to approximately 68,000 under ICD-10; the volume of procedural codes will increase from about 3,000 to approximately 87,000 — an increase of 2,800 percent.

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Originally published on: Biz Journals

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