New change in Medicare billing codes

The updated codes were  implemented Oct. 1, adding over 50,000 new options.

When you go to the doctor with an illness, Medicare uses a set of codes called the International Classification of Diseases to categorize it, as well as surgeries and other procedures, when the bill is prepared.

The International Classification of Diseases, or ICD, is used by the World Health Organization. As a member of the WHO, the United States uses the ICD. Many industrialized nations have already switched to ICD-10.

This month in the U.S., ICD-10 went into effect with 69,000 codes. It replaced ICD-9, which had 17,000. ICD-9 had been used since 1979. Many argued it was time for an update.

Medical providers have been anticipating the change for months, but the switch to ICD-10 requires nothing from patients.

Seniors should look forward to greater detail in the codes. The new codes contain more detailed entries, and “specify the types, locations and severity of conditions and injuries.” The codes will also grow from 3-5 digits to 7, allowing for greater specificity.

Before, there were no differences in codes to describe which side of the body has a pain, or had a procedure. Now, more than 40% of the new codes contain that distinction. The implementation of ICD-10 could bring slight changes in payments and coverage, so be sure to check with your doctor if you have any questions.

This image shows the differences in categorizing a femur fracture using ICD-9 and ICD-10. From Roadto10.org.

Click here for Medicare’s ICD-10 page.

For a list of FAQ’s on ICD-10, see this helpful list
from Humana’s website.