ICD-10 Goes Live

Many SHARE members have been working very hard to prepare for today. We wish you well this week! It’s been years coming, and, as you’ve probably heard, the ICD-10 coding system goes live today, in healthcare facilities around the country, including our own hospital. The current 19,000 codes used to define healthcare diagnoses, treatments, and procedures will expand to cover 142,000 unique codes.

It will be a big transition, and transitions always involve unknowns. But SHARE coders couldn’t be better prepared, and we’re well-situated to take good care of our hospital.

Kathy Girouard (pictured), a member of the SHARE Executive Board, and a coder in the Heart and Vascular Interventional Laboratory (HVIL), explains that the job has always been difficult, and misunderstood. “A lot of my friends outside the hospital don’t understand what I do at all. Sometimes they even ask me, ‘Kathy, what do you do all day with codeine?’ The whole idea of coding is new to them.”

“When you’re doing the kind of coding that I do, you basically have to decipher a physician’s notes to figure out what they did with the patient. You end up having to understand procedures almost like you’re the doctor,” Kathy says with a laugh.

Coders at UMass Memorial have invested a lot of their time preparing for the new coding system. Some have likened it to speaking an entirely new language. A recent article in Scientific American, “Why You Should Care About the New Major Changes in Medical Billing,” explains that the new codes are often extremely specific. For example, the new codes can pinpoint more precisely the location of bone and tendon injuries, or the particular trimester of a pregnant patient.

The information is necessary to properly reimburse the hospital for the care it provides. The massive overhaul has some industry analysts worried that reimbursements will be delayed, or that errors will leave hospitals with some services unpaid altogether. Some physicians in other hospitals worry that treatment authorizations could be delayed, too. The Centers for Medicare and Medicaid Services, anticipating some confusion, has pledged to honor valid insurance claims that are within the right category, even if the specific code isn’t exactly right.

“We’re as ready as we can be,” Kathy Girouard says of the coders. Although that job title is now a hot commodity on the job market, SHARE members plan to use their years of experience to transition and implement the new coding system right here. Many have trained intensively for hours each week for the past two years.

The short-term effect of the new codes will likely involve some confusion throughout healthcare. However, in the long-term, the compilation of more specific data is expected to lead to better understanding of some medical conditions, breakthroughs in treatment, and better diagnosis of problems within healthcare delivery itself. We’re looking forward to using the new knowledge to take even better care of our patients, and proud of the work that SHARE members have done to get us here.