KESTNER: Massive changes coming in your healthcare system

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In addition to Obamacare, there are two enormous changes unfolding behind the scenes in healthcare and both will affect you. Today’s column will address one of those changes.

One of the most significant changes to apply to healthcare will be the switch from a standard in how your diagnoses are recorded, stored and shared among providers, insurance companies and the government.

For many years, physicians, hospitals and other healthcare providers have used a book called International Classification of Diseases (ICD) to record and communicate about the enormous range of potential diagnoses that may apply to a patient.

Every conceivable diagnosis has been assigned a 3-5 digit numerical value that is associated with the description of the disease or condition. For example, if you visit a doctor and are diagnosed with the flu along with upper respiratory conditions such as cough and congestion, the doctor’s office may record your diagnosis as 487.1. Any provider or insurer in the world would be able to find that this number refers to “Influenza with other respiratory manifestations.”

Likewise, a different code set is used to communicate information about various services and procedures provided in healthcare offices. This code book is called Current Procedural Terminology or CPT. There is a CPT code for most services that you might encounter during a visit to any office providing healthcare.

For example, had you gone in for a flu shot in an attempt to avoid coming down with the flu, your provider may record that they provided CPT 90657. Any provider or insurance company in the world could immediately recognize this code as indicating that you received an influenza vaccine.

As the world of healthcare diagnoses and treatment options expand each year, these code books are updated. Currently we are using the code set known as ICD-9. This is the most current collection of codes and is universally used by all facilities and other parties to accurately and efficiently relay information about a patient’s condition.

However, as the database of variations on diagnoses is expanding, it has been determined that the current standard of 3-5 numerical digits will no longer suffice to accommodate the increasing amount of data that needs to be transmitted, so a completely new standard has been developed. Thus, the emergence of the next version of the code set known as ICD-10 will be a completely new system of numbering rather than a simple update as we have seen for so many years.
Beginning Oct. 1, 2014, everyone involved with healthcare will be required to use the new codes in ICD-10. These new codes are very different and will now have letters in addition to numbers.

Although this sounds like a relatively minor change, in effect it is a huge challenge for the entire healthcare industry to make such a significant change.

The change is reminiscent of when the year 2000, otherwise known as Y2K, approached and suddenly everyone realized that our entire world-wide collection of computers had been operating using only two digits to describe the year, rather than four.

For readers that may be too young to recall the emergence of this century, many people watched with anxiety as the year 2000 came, wondering whether the electric grid would fail, whether air traffic control systems would collapse, whether any computer systems would operate properly at all.

Since many systems had originally been built using only two digits for the year, it was conceivable that the confusion of hitting year 2000 would simply refer to the year 00 and create havoc among computer based components of our infrastructure.

As it turned out, the combined efforts to prepare computer systems for the switch to four digit compliant operating systems was largely successful and the world continued spinning just as it had during the previous century.
The seemingly small change in the numbering system to report diagnoses is likely to have a major impact on the way healthcare is delivered and managed similar to the impact that the two digit change had on computer systems as we transitioned to this century.

Learn more about the anticipated and possibly unanticipated outcomes of this monumental change in next week’s Post. Not only are there big changes in how you will receive healthcare, but critics point out that this is another step toward Big Brother power base expansion.

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care, dr. kestner, health, mark, obamacare
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Members Opinions:
March 16, 2014 at 7:28pm
Anticipating the angst of October 1st, we've developed and recently released an app that may help alleviate the anxiety related to the ICD-10 implementation. Especially for the small practices that don't have the support or budgets of a hospital HIM department.

You can check it out at

Your feedback would be much appreciated
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