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What Does the New U.S. Medical Coding System Mean to You?

by Community Outreach and Philanthropy, (928) 771-5686 | Sep 14, 2015
Do you have a “standing order” for blood work at a local laboratory? Has your healthcare provider recently written you an order for medical services you may not use until after October 1st? If so, you may want to contact your provider – physician, nurse practitioner or physician assistant – to request an order with the new diagnostic code that will be launched nationwide on October 1st.

On that date, healthcare providers in the U.S. – including physicians, hospitals and other medical practitioners – are required to convert to a new diagnostic coding system. ICD-10, as it’s called, will replace ICD-9 as the “clinical code set” healthcare providers use for healthcare service orders and medical records. These codes ensure patients are receiving the prescribed treatment for their respective conditions and allow providers to be paid for the services they deliver.

According to Dee Betts, Director, Health Information Management at Yavapai Regional Medical Center (YRMC), healthcare providers and payers (health insurance companies) nationwide have been preparing for this change for several years. However, because it’s new information for most consumers she wants western Yavapai County residents to be aware that converting a medical order from ICD-9 to ICD-10 is not a simple translation.

“When you translate from one language to another, it’s not a 100 percent exact match,” Betts said. “However, with more information you can translate and communicate effectively. The ICD-9 to ICD-10 change is no different. Some diagnoses will translate directly, but there are many conditions that will require additional information in order to select the appropriate code.”

For example, under ICD-9, a fracture of the tibia (leg) is a single code. With ICD-10, the code for that same injury includes information on whether the left or right leg is fractured and what portion of the tibia – top, middle, bottom – is injured.

Here’s some tips from Betts on how you can determine if your medical order is written in ICD-9 or ICD-10 code:

  • Look for letters—ICD-9 codes are numeric while ICD-10 diagnostic codes begin with a letter.
  • Count the numbers—ICD-9 codes have a maximum of five digits and may include a decimal point. For ICD-10, the maximum code is seven digits and there also is a decimal point. Be aware that both code sets may use only three digits.

Do you have an old ICD-9 medical order? Betts advises you to call the office of the physician, nurse practitioner or physician assistant who wrote the order and ask for a new order.

“Doctors, nurse practitioners and physician assistants are the only healthcare providers in Arizona who are allowed to write medical orders,” Betts said. “Your provider knows your diagnosis and the treatment he or she is prescribing so that individual needs to update any medical orders.”

Betts said the healthcare community nationwide is ready for the October 1st change and most people won’t even notice the conversion.