Today, October 1, marks the first day of the new ICD-10 medical coding system and a large shift in how doctors record visits and bill insurance providers. The 137,000 new medical codes cover everything including being bitten by a turtle (W59.21XA), struck by a turtle (initial encounter, W59.22XA), or your follow-up appointment after being sucked into a jet engine (V97.33XD).
Doctors are expecting that the shift will result in temporary delays as they and their computer systems adjust to the new codes.
The previous system, the ICD-9, was created in the 1970s and has been an international standard in medical coding ever since. The ICD-10 intends to build on this with more precise information that is meant to improve patient care and provide a better understanding of injuries and disease. Although the ICD-9 was functional, it lacked precision on certain matters. For instance, a lookup of the keyword “bleed” in ICD-9 produces limited results that fail to recognize bleeding from a host of different intestinal disorders including Crohn’s disease.
One of the main changes in the ICD-10 is more precise codes that describe the circumstances of an injury or the precise part of the body that is harmed. While the medical value of knowing that your burn came from an inflatable raft catching fire (V91.06XA) may be limited, it could prove useful to anyone interested in product safety. Similarly, the extensive number of codes for various means of self-harm could offer more insight into both successful and unsuccessful tools for preventing suicide. There are also individual codes for specific sites in which an injury takes place—such as a post office (Y92.242), library (Y92.241), or medical office (Y92.531)—that may be of value to the Occupational Safety and Health Administration (OSHA).
Critics of the ICD-10 have pointed to the number of more humorous-sounding codes, such as walking into a lamppost (W22.02XA) or being bitten by a pig (W55.41XA). There has also been some misunderstanding about the use of the phrase “subsequent encounter” in many of the codes. A subsequent encounter refers to a repeat physician visit, not a reoccurrence of the injury.
Sources for Today’s Article:
Christensen, J., “ Bit by a squirrel? There’s now a code for that (W53.21XA),” CNN web site, last updated October 1, 2015; http://www.cnn.com/2015/10/01/health/medical-code-change/index.html.
“ICD-10 Code Lookup,” Centers for Medicare and Medicaid Services web site; https://www.cms.gov/medicare-coverage-database/staticpages/icd-10-code-lookup.aspx?, last accessed October 1, 2015.