Affordable Care Act Making Medical Facilities Switch Coding Systems

- Over the past several months we've shared with you several provisions of the Affordable Care Act and how it may affect you.

Now doctors and medical facilities in Texoma and across the country are preparing for a new way to code your visit when it's submitted for insurance.

The provision has a deadline of October 1st of this year.

ICD-10 is basically going into even deeper detail when doctors code your diagnosis. It's a system used already in other parts of the world but is not mandatory in the U.S. That is, not mandatory until later this year. A switch over will be taking place, that depending on facility, could be a pretty costly change.

When patients enter Healthsouth Rehabilitation Center in October their diagnosis forms will be rolled out with more detailed codes then ever before,

“If a patient has a fracture, they no longer can say fracture. They have to document where the fracture is, the type of fracture, is it a spiral fracture, a complete fracture, is it a hairline fracture, is it in the right leg, the left leg and there will be different prefixes and sequences that go with that,” says HIMS Supervisor/Coder, Marci Berg.

Adding those extra details means thousands of new codes need to be learned.

“We're gonna be using letter prefixes instead of just our number sequences, going from about 1,200 codes to, like most hospitals and medical facilitates are used, to up to over 5,000,” says Berg.

It's a switch requiring new software and training that, for a company as large as Healthsouth, comes with a cost that can be absorbed easier. However, for smaller organizations, it could be a budget buster.

Berg says as far as her office is concerned, once they get past the learning curve, the new codes should make things easier because the extra information will help doctors provide a more tailored treatment plan.   

“You're gonna have a specific diagnosis which is gonna help in the long run,” says Berg.

And to make sure the transition goes as smooth as possible, coders at Healthsouth are currently taking online classes on the system and will be getting some hands on training later this year.

“At the beginning of summer, we will go down with our southwest regions to one locations with a trainer on site to guide us through the groupers and things that we have. We're trying to get a lot of tools incorporated to help us group those codes together and have it a little more user friendly,” says Berg.

Again, the coding changes will start in October and will apply to all medical facilities regardless of your type of insurance plan.

If your medical facility needs to be trained in the new ICD-10 training system, next month there will be a training session you can attend.

It will take place on April 3rd 8:30 a.m. at the Wichita Falls Public Library.

Click here to sign up.

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