Monday Medical: There’s a code for that
August 2, 2015
While the world of medical coding may not seem all that interesting, it's certainly important to many aspects of healthcare.
Currently in the U.S., hospitals use ICD-9, or the International Classification of Disease — ninth revision. The system is used to record medical situations including injuries, illnesses, diseases, symptoms, causes and locations of injury, complications, etc. Essentially, the codes record and specify the medical issue a patient has experienced, including details of the situation leading to the injury. While there are currently more than 13,000 codes under ICD-9, the U.S. is about to upgrade to ICD-10 on Oct. 1, and it includes more than 69,000 codes.
In short, medical coding is about to get a lot more specific, with each code conveying more detail than the current system.
Upgrading to such a robust classification system is not easy. It requires considerable expense and time commitment from many in the healthcare industry.
At Yampa Valley Medical Center, testing and education encompass the biggest commitments.
Testing with the government, payers, providers and software has been ongoing and in conjunction with the current system to ensure a smooth transition in October.
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Education has been extensive for physicians and hospital staff. Specifically, YVMC's medical record coders have been attending trainings and demanding "boot camps" to hone their knowledge on ICD-10.
All of the expense and time involved in converting to ICD-10 raises the question: "Why?"
The American Health Information Management Association makes the case that a better system affects many aspects of healthcare and, ultimately, improves the quality of patient care.
Better measurement and data analysis
Because each code holds more data, analyzing them for trends, connections, efficiencies, costs, complications and outcomes will only improve the healthcare system, including the ability to identify and treat patients more effectively and with a higher level of care.
The rest of the developed world already uses ICD-10, in part because government healthcare in those countries removes complicated billing issues. As a result of upgrading, The U.S. will be able to better share and track public health information and respond to global medical threats faster.
Medical research will certainly improve because analyzing codes is often used when access to patients after the fact isn't possible. With more detail conveyed in each code, previous relationships between medical procedures and health issues will be tracked more easily and clearly.
Reimbursement and coverage
Better coding will improve the system of providing payments for services, help eliminate errors in reporting services and better identify medical issues and treatments that are easier to justify as necessary.
There's a code for that
So while the new coding is very specific — such as abscess of left upper eyelid, (H00.034) or second degree burn of right thumb (T23.211A) — the degree of specificity means there are some pretty unlikely-to-occur codes. Here are a few you might find interesting.
• V97.33XD: Sucked into jet engine, subsequent encounter — If somehow you manage to survive being sucked into a jet engine, only to be sucked in again, there's a code for that.
• V05.11XA; Pedestrian on roller-skates injured in collision with railway train or railway vehicle in traffic accident, initial encounter — The amount of codes involving various, yet specific collisions is extensive.
• Y92.146: Swimming-pool of prison as the place of occurrence of the external cause — If you're injured during an afternoon dip during your next prison stay, there's a code for that.
• Y93.D1: Activity, knitting and crocheting — The codes get specific regarding injury during an activity. If you're injured while vacuuming (Y93.E3), milking an animal (Y93.K2) or while playing a wind or brass instrument (Y93.J4), there's a code for that.
• W56.22XA: struck by an orca, initial encounter — There is actually a whole category if incidents involving contact with specific animals, including turkeys, raccoons and nonvenomous lizards.
• V91.07XA: Burn due to water-skis on fire, initial encounter — Is it possible for water skis to catch on fire? Apparently so. There are nearly 30 codes related to water skiing injuries.
Nick Esares is a marketing and communications specialist for Yampa Valley Medical Center. Information from the American Health Information Management Association was used in this article.
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