DAVENPORT, Iowa - Oct. 1, 2015 -- Betsey Tibbitts recalls first looking over ICD-10 medical codes in the early 1990s when they were already being used in some countries.
Nearly 25 years later, Thursday was launch day across the United States for tenth revision of the International Classification of Diseases (ICD).
"Other countries have been using ICD-10 for many years but they don't use it for reimbursement purposes the way we will in U.S.,'' explained Tibbitts, information services administrator and corporate privacy officer, Genesis Health System. "The version we will use in this country had to be much more complex and took much more time to get implemented.''
There have been numerous delays to implementation in the U.S. Implementation was finally set at Oct. 1, 2015 after a number of extensions in the deadline.
Compared to other countries, the U.S. was late in introducing ICD-10. Australia has been using ICD-10 with its own modifications since 1998. Canada introduced ICD-10-CA, its modification, in 2000. Tibbitts said it has been eight years since the last country transitioned to ICD-10.
"The reimbursement piece is something that other countries aren't using ICD-10 for. That made it much more difficult to switch over to ICD-10 in this country,'' she added.
Genesis hired a consultant in 2012 to evaluate a successful transition to ICD-10. Ten teams have been working on implementation. Last spring, Genesis began dual-coding - using both ICD-9 and ICD-10 - to prepare for Thursday.
The transition to ICD-10 was necessary because ICD-9 was exhausting code possibilities with a five-character alphanumeric system to describe diagnoses. ICD-10 is based on a seven-character system.
Instead of about 18,000 codes for ICD-9, there are now about 139,000 with ICD-10.
"It has certainly made coding much more difficult and there are more jobs for new and experienced coders, which is a good thing for coders,'' Tibbitts said. "It is kind of like nursing positions right now. There is competition for experienced coders and they are being paid better.
"Each patient will take longer to code. There will be a loss of productivity, requiring more coders to handle the same volumes.''
What does ICD-10 mean to patients?
"There may be some initial delays from the time of care to the time when the patient receives a bill,'' Tibbitts added. "We expect the claims process to slow down.''
Patients and the general public may also be amused by the specificity of codes. A team at the World Health Organization, which develops ICD, must have had fun thinking of every possible diagnosis.
For example, code W56.22xA is Struck by orca, initial encounter.
V97.33XD is sucked into a jet engine, subsequent encounter.
V06.00xA is Pedestrian on foot injured in collision with other nonmotor vehicle in nontraffic accident, initial encounter. In other words, "Grandma Got Run Over by a Reindeer.''
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