Working with our partner, Universal Health Network, we’ve learned a lot about medical billing and all of the changes that are coming up.  Terms like ICD-10 and meaningful use have been floating around since this time last year, but like many others out there, we didn’t have the specifics. 

First, it is important to know what the difference is between ICD-10 and its predecessor; ICD-9.  Coders will have to go from knowing 13,000 diagnosis codes to a whopping 68,000 codes with ICD-10. If you’ve been wondering what people have been complaining about, this is it. Imagine the knowledge needed for you skill set growing to more than six times its size and trying to keep up.  Inconveniently, there are no simple conversions from ICD-9 to ICD-10.  Some codes here and there are remaining the same, unfortunately the new system is much more robust. Taking one code and breaking it down into many more specific codes now, the ICD-10 codes even look different.  Previously, codes were only 3-5 characters, while now they can have up to 7 characters.

Now, why was it necessary to make all of these changes if the system worked before?  Well, think about how fast technology has changed over the last few years. There’s literally a new iPhone every other year and people all across the world immediately adopt that new technology.  Now think about the medical advancements that are being made daily.  Every year there are newly identified medical conditions and brand new treatments and medical devices discovered.  Just to give you an idea of how desperately these changes were needed, ICD-9 had been around since 1979.

(Medical Advancements from 1979 to 2003 via: AAMC)

1979 First use of the immunosuppressant drug cyclosporine, now standard therapy for organ-transplant patients

1980s Development of coronary angioplasty

1980 First acute spinal cord injury intensive care unit

1981 First successful surgery on a fetus in utero

1981 Establishment of the first Pediatric Trauma Center

1981 First successful human combined heart/lung transplant

1981 Development of the first artificial skin made from living human cells

1981 Descriptions and reports of the nation’s first cases of AIDS

1981 Development of balloon angioplasty

1983 First performance of autologous bone marrow transplant for acute myeloid leukemia

1984 First successful pediatric heart transplant

1985 First Fetal Cardiovascular Center

1986 First hospital to initiate a lung transplantation program

1986 First use of lithotripsy to break up common duct gallstones

1988 First successful double-lung transplant

1989 First living-donor liver transplant, and in 1993, the first liver transplant from an unrelated living donor

1989 Identification of human umbilical cord blood as a suitable source for stem cell transplantation

1993 First Geriatric Research and Training Center

1993 First human gene therapy trial for cystic fibrosis

1993 First gene-therapy procedure on a newborn infant, correcting an inherited disorder of the immune system

1994 First use of functional MRI to provide rapid diagnosis of most strokes

1994 First gamete intrafallopian transfer for treatment of female infertility

1994 First human retinal cell transplant

1995 First implantable, artificial inner ear for treatment of deafness

1995 First deep brain stimulator implantation for the treatment of Parkinson’s disease

1996 Development of computer-assisted stereotactic neurosurgery

1997 First use of gene therapy in cardiac disease in humans

1997 First stem cell transplant for active lupus

1997 First retinal transplant

1997 First transplant of human fetal tissue in patient with spinal cord injury

1998 First laryngeal transplant

1999 First hand transplant

2000 First quadruple transplant of four organs—a kidney, two lungs and a heart—from a single donor

2000 First bioengineered cornea transplant

2001 First implantable replacement heart that functions without a permanent attachment to a power source

2001 Discovery of stem cells within the pancreas that can generate insulin-secreting beta cells

2002 Development of a Rapamycin-coated stent, a breakthrough in the prevention of restenosis following cardiac catheterization

2003 First successful larynx reconstruction accomplished using tissue taken from patient’s arm


The time to make changes will be up on October 1st this year and those who have not taken steps to prepare for ICD-10-PCS will be left in the dust.  This transition period is predicted to be rather turbulent for providers across the board, even 1/3 of hospitals still haven’t started their ICD-10 education.  Those who haven’t been getting ready have a couple of options at this point:

-       begin training with ready-made education programs

-       out-source your coding to a medical billing company

Having your coding managers in-house certainly has its pros, but with these changes, getting by with your current systems will prove very difficult.  When it comes to coding, the margin for error has grown and with reimbursement cuts, it is increasingly more important to be accurate.

Are you ready for October 1st?