Those working with patient records in the healthcare industry are asking the important question, "How is medical coding changing?" This deserves careful consideration since medical coding involves the inputting of patient data for billing services, according to the American Academy of Professional Coders. Medical codes help to document all aspects of patient care, including: the level of services completed, the diagnostic procedures performed, the treatment protocols provided, and the accounting of supplies that may have been used. Additionally, medical coding provides insurers the correct information to properly bill patients and healthcare providers for medical care received.

Significance of Medical Codes in the Healthcare System

Medical coding took on greater value when two events became realities: the Health Insurance Portability and Accountability Act of 1996 (HIPPA) and computerization of records. HIPPA held healthcare providers accountable for accurately tracking patient care, and computerization gave the means to do so more easily. Since medical coders are responsible for understanding and inputting codes, changes to the medical coding system are of serious concern because codes that are incorrectly used compromise patient care and services.

ICD-9 and ICD-10 Codes

According to the American Medical Association, medical codes are federally regulated, so healthcare providers must comply with any new coding standards that take effect. The current code standards, ICD-9, are scheduled to be replaced by October 1, 2015 by ICD-10, as reported by the Department of Health and Human Services on August 4, 2014. Healthcare providers are being held accountable for switching over to the new coding standards by the deadline and may face penalties if they are not in compliance. The date for compliance is actually an extension to help medical providers prepare for the changes. In part this is due to a significant increase in the number of codes that ICD-10 expects medical coders to implement.

How ICD-9 Differs from ICD-10

ICD-10 increases the complexity of the medical coding system to account for the numerous medical advancements that have occurred since ICD-9 was implemented. While ICD-9 currently uses about 17,000 different codes, ICD-10 is expected to use more than 150,000. This is the primary reason why an extension was granted, to afford medical coders the time to be trained proficiently in the use of the new codes. Professional organizations, like the American Academy of Professional Coders (AAPC) and the American Health Information Association (AHIMA) are already providing training and resources to assist medical coders with this transition.

What Healthcare Providers Can Expect

Medical coders have always needed to be proficient at understanding medical terminology, but there will be much more of it in ICD-10. Coders are recommended to review anatomy and physiology terms to help them become more comfortable with the language of the new codes. Another important recommendation is to troubleshoot new software or computer formats that will be used with ICD-10. Having familiarity with this part of the process will help healthcare providers resolve any technical problems prior to the compliance deadline. Finally, healthcare providers should be aware of how existing insurance provisions and new healthcare exchange programs may be affected by changes to coding system.

Related Resource: Patient Financial Specialist

Medical coders will be up to the challenge of ICD-10 with the appropriate training and support. In view of this, healthcare providers should review how medical coding changing will affect their programs and plan accordingly for the smoothest transition possible.