The federally mandated transition to ICD-10 will result in an eightfold increase in the number of diagnostic and procedure codes from 17,000 currently to more than 140,000. The new codes capture more detailed data on everything from pregnancy symptoms in different trimesters, to a leg break on the left side versus the right side. Doctors, nurses and coders are undergoing a lot of training to get the new billing process right.
"It's kind of like going from speaking and writing in English, to speaking and writing in a different language," Cardenas explained.
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The hospital coding staff has been undergoing system testing with their health IT vender, Cerner, to make sure they're ready for Oct. 1.
"So far, the tests are going well," said Cerner President Zane Burke.
For one week this winter, the company conducted end-to-end testing with more than 100 clients and the Centers for Medicare and Medicaid Services. For their hospital clients, the processing has been an eye opener.
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"So many things trigger off of that information and so many downstream processes can be impacted by that," said Burke. "What they're working on is what are those billing impacts, as well as the patient flow. "
Under ICD-10, it will be very important for doctors to document a patient's specific symptoms in order to get paid. For example, a code for simple pneumonia would not trigger any reimbursement for hospitalization, while the new code for granular pneumonia does include intensive care treatment. Without careful documentation, the wrong codes will trigger billing and payment problems.
Yet, with just six months to go until the changeover, the biggest concern for providers is how well the government and private insurance payment processing systems will work.