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(c) 2016 Jon L Gelman, All Rights Reserved.

Thursday, April 10, 2014

Doctors' Billing System Stays Stuck In The 1970s For Now

Much of the health care industry spent millions preparing for a huge upgrade of coding for medical diagnoses and procedures that has now been delayed. i
Much of the health care industry spent millions preparing for a huge upgrade of coding for medical diagnoses and procedures that has now been delayed.

Much of the health care industry spent millions preparing for a huge upgrade of coding for medical diagnoses and procedures that has now been delayed.

Courtesy of Intelicode

For doctors, hospitals and insurance companies, all the complexities of medicine get boiled down into a system of codes.

These codes are used to track and pay for every procedure you can think of. There's 813.02 for mending a broken forearm, and 800.09 for treating a concussion. There's even 960.0 for being hurt in an "unarmed fight or brawl."

But this coding system is now four decades old. The codes were scheduled to be upgraded in October, but last week Congress delayed the switch.

JaeLynn Williams, for one, is seriously bummed out. "It's kind of like looking forward to Christmas, and it doesn't come," she says

Williams and her company, 3M Health Information Systems, are helping about 5,000 hospitals upgrade from the old coding system, called ICD-9, to the new one, ICD-10.

It's a $100 million project for 3M Health. Williams is passionate about the upgrade since it will give doctors, hospitals, researchers and insurance companies better data — which will allow them to zero in on the best, most cost-effective treatments.

"With ICD-9 there's only so much information that's captured with each code," she says. ICD-9 offers about 4,000 codes for procedures. ICD-10 has about 72,000.

Without very specific codes, cardiologists, for example, can't...

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