Healthcare Billing Gets Really Specific

Doctors now can indicate which side of a patient’s body needs surgery or whether he got a concussion in a baseball game or a soccer game, under long-anticipated healthcare billing codes that went into effect Thursday.

Healthcare providers around the country have spent years preparing for the new coding system, after the Obama administration twice delayed its implementation. Known as ICD-10, it expands the number of diagnostic codes from 14,000 to about 68,000, dramatically increasing the specificity of information doctors can transmit to insurers to get paid.

There could be some glitches as providers adjust to the new system, although those won’t be known for a few more days since doctors won’t immediately bill for healthcare services performed starting Oct. 1. And some experts fear that insurers could reject more claims, as they scrutinize more specific codes to see whether certain services were medically necessary.

But overall, providers and insurers say they’re prepared for the transition. They say an update to the billing codes was long overdue, since the current ICD-9 system has been in place since 1979. Under the old system, doctors couldn’t make basic differentiations such as specifying whether a patient had Type 1 or Type 2 diabetes.