The ICD-10 will replace existing coding for medical diagnoses and inpatient procedures. It will apply to all health plans and providers governed by the Health Insurance Portability and Accountability Act of 1996.
Let the Nightmare Begin
For starters, the number of medical codes for various diagnoses and disease conditions will increase from about 18,000 to about 155,000 different codes.
The system has gone from the sublime to the ridiculous. As Steven Syre of The Boston Globe observed, “The new medical code book demands highly specific details about where an injury took place. It’s not good enough that it happened at a cultural event. There are separate codes for injuries at museums, art galleries, music halls theaters, and opera houses.”
What is Known For Sure?
The system will be costly to implement since the current medical software systems used by insurance companies and providers will need an over haul. Staff will requiring intensive training (both on the insurance and the provider sides of the aisle). It is inevitable that providers will take a financial hit as they struggle to accurately code a myriad of disorders.
There are 127 ICD-10 codes that include the word “hearing” and the description of many of the codes is open to interpretation, for example:
2014 ICD-10-CM Diagnosis Code H90.4
Sensorineural hearing loss, unilateral with unrestricted hearing on the contralateral side
Unrestricted means???? Unimpeded, not limited, free…pick one??? Not once did I ever use any of those terms in a patient’s chart.
H90.4 is not a billable ICD-10-CM diagnosis code and cannot be used to indicate a medical diagnosis as there are 2 codes below H90.4 that describe this diagnosis in greater detail.
In other words H90.4 exists to direct you to dig deeper.
2014 ICD-10-CM Code H90.41
Sensorineural hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side.
Below are the description synonyms associated with H90.41, they’re supposed to help you figure out which code to use.
Hearing loss, sensorineural, right · Right autoimmune sensorineural hearing loss · Right high frequency sensorineural hearing loss · Right neural hearing loss · Right sensorineural hearing loss
How to Learn About ICD-10 Codes
The Center for Medicare/Medicaid Services (CMS) Sponsors ICD-10 Teleconferences
MLN Connects™ National Provider Calls (MLN Connects Calls) and videos help prepare the provider community for the U.S. health care industry’s change from the ICD-9 to ICD-10 medical coding system. These calls and videos are free of charge. Refer to the list below for information about upcoming or previous MLN Connects Calls and videos, including registration information, links to call presentation materials, written transcripts, audio recordings, podcasts, video slideshow presentations, and other related materials. MLN Connects is a part of the Medicare Learning Network® (MLN)*
What Do I think Will Happen?
The House of Representatives recently passed H.R 4302, a temporary “fix” to the Medicare payment system that would prevent a 24 percent cut in Medicare payments this year. The bill would also delay the Obama Administration’s implementation of the new ICD-10 coding system, which is scheduled to take effect on October 1, 2014.
If you’ve never written to your congressman/woman before today, now might be a good time to start.