Doctors launch new coding system

Health care providers and organizations are adjusting to the presence of a long-awaited tool: ICD-10.

ICD-10, an acronym for the International Classification of Diseases 10, is a code system physicians use to bill for visits and record medical conditions. The ICD-9 system has been in use in the U.S. since 1979, and is missing codes for some diagnoses that are becoming more common.

The transition to ICD-10 has been in the works for years and has been equally anticipated and dreaded by health care providers. The World Health Organization released ICD-10 in 1993, and the U.S. health care system has been attempting to incorporate it piece by piece since at least 1999, according to the American Health Information Management Association.

The Oct. 1 deadline saw the implementation of the new code system across the U.S., and organizations on the peninsula have been preparing for a long time.

Peninsula Community Health Services, which has three clinics in Soldotna and Kenai, has been working with staff to ensure an easier transition for years, said Monica Adams, CEO of PCHS. The organization knew the system was coming a long time out, so that gave them time to prepare everyone, she said.

“What we’ve done to prepare was that we upgraded our (electronic health records) system, we offered internal training and web-based training, and there’s been local training at the hospital that some of our providers went to, and others got some training on their own,” Adams said. “Some people are nervous about it, but I think everybody’s prepared.”

PCHS was abuzz with chatter over diagnosis codes Thursday morning, more so than ever before, Adams said. Coding specialists are available to staff to help them with the new system, and some of the staff put together “ICD-10 survival kits” with tools such as magnifying glasses to help read the small codes, she said. The center is also blocking out time throughout the month of October for physicians to review codes and ask questions, she said.

“Everybody knows what’s happening, and we’re trying to make it fun,” Adams said. “We want it to go well from our perspective as well as from the perspective of our patients.”

Based on sheer size, the transition is a quantum leap — while ICD-9 had approximately 13,000 diagnosis codes, ICD-10 has 68,000, more than five times as many.

It’s not just for billing, either. The codes are much more specific in the new system, allowing providers to indicate individual conditions for more accuracy and continuity in the medical record, Adams said. ICD-9 is missing many codes, and the update should allow physicians to provide better care to patients, she said.

“Every industrialized country in the world is on ICD-10,” Adams said. “It’s a good movement, but like anything, it will be a little tough at first. It’s good we’re finally doing it.”

Because the system is brand new, there is potential for errors. The national Center for Medicare and Medicaid Services announced in July that it will still accept medical claims that have some coding errors, as long as the codes are in the same “family,” for a year after Oct. 1 to ease the transition for many providers.

Central Peninsula Hospital has been at the eye of the whirlwind for the peninsula. The hospital began prepping for the system to arrive in 2013, and when it was delayed from a 2014 launch, reintroduced its training programs at the beginning of 2015. So far, it has been relatively seamless, said Marianne Dailey, director of health information management for the hospital

“There haven’t been any hiccups,” Dailey said. “It’s kind of a nonevent, like a Y2K. It’s been very quiet here today.”

The uneventful rollout today may not mean a faultless transition, however. Dailey said the true effects probably won’t be visible until Monday, when claims filed today begin coming back from CMS and insurers, she said. However, at that point, it is out of the hospital’s hands — if they are doing everything right, it may be that the insurers and CMS are not ready yet.

ICD-10 required a significant technological update. The hospital is in the process of purchasing a new EHR system, but to implement ICD-10 at all, Dailey and her staff had to update all the hospital’s computers, including the systems at the CPH clinics and Heritage Place, the nursing home owned by the hospital.

Over the two years the hospital has been preparing for the transition, staff have been able to schedule face-to-face meetings with Dailey and her team to discuss coding concerns and documentation issues. They were able to use online modules as well to prepare for the transition, and there are coding specialists available to help now that the system is active, she said.

But she said there isn’t much to worry about on the hospital’s end.

“To quote Benjamin Franklin, ‘An ounce of prevention is worth a pound of cure,’” Dailey said. “I feel really good about it.”

Reach Elizabeth Earl at elizabeth.earl@peninsulaclarion.com.

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