Obamacare Increases Medical Billing Complexity Nearly 5-fold

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When squirrels attack! There’s a medical code for that.
BY SARAH KLIFF
February 14 at 10:56 am

The prospect of quadrupling the number of medical codes used in those calculations has touched off a heated debate over whether more specificity is an onerous layer of bureaucratic red tape — or a valuable chance to better understand and treat complex medical conditions.

The codes in ICD-10 can seem absurd in their granularity, replete with designations for seemingly impossible situations.

There are different numbers for getting struck or bitten by a turkey (W61.42 or W61.43). There are codes for injuries caused by squirrels (W53.21) and getting hit by a motor vehicle while riding an animal (V80.919), spending too much time in a deep-freeze refrigerator (W93.2) and a large toe that has gone unexpectedly missing (Z89.419).

At the AAPC conference in San Francisco, the organization sold shot glasses inscribed with “F10.950” — the code for an unspecified alcohol-induced psychotic disorder. “Give ICD-10 a shot!” it says in blue script.

Hospitals and insurers have fought the new codes, calling them a massive regulatory burden that will cost them billions of dollars to implement without improving patient care. For years, their protests succeeded: The federal government has twice delayed implementing the new code set, which was initially set for 2008.

ICD-10 proponents contend that adding specificity to medical diagnoses will provide a huge boon to the country. It will be easier for public health researchers, for example, to see warning signs of a possible flu pandemic — and easier for insurers to root out fraudulent claims.

“How many times are people going to be bitten by an orca? Probably not very many,” said Lynne Thomas Gordon, chief executive of the American Health Information Management Association. “But what if you’re a researcher trying to find that? You can just press a button and find that information.”

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