How doctors are at the mercy of ICD coding

January 11, 2009

What’s the difference between ICD codes 401 and 401.0 for hypertension?

Plenty, as Dr. Rob points out. It can mean the difference of whether the physician is paid for the visit or not. He points out more inane examples, such as a positive rapid strep test that gets paid when diagnosed as “pharyngitis,” but not when it’s coded as “strep throat.”

Coding is an important aspect of medicine that isn’t taught well during residency training. It took me about 2 years to learn the ropes, and I admit, I’m still not clear about some coding rules. There is an entire profession dedicated to coding that physicians are expected to just pick up while on the job.

And imagine, the coding morass is about to become exponentially worse with ICD-10, the next iteration that expands the number of the codes five-fold.

If you’re looking for a job, the medical coding business is going to be a hot field going forward.



Related posts:

  1. Coding complexity
  2. Coding clinic
  3. Profiting from the coding complexity
  4. How electronic medical records can lead to coding fraud, and get doctors into major trouble
  5. Don’t blame physicians for coding
  6. "Correct coding is impossible"
  7. The game of Medicare coding


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{ 2 comments }

1 The Happy Hospitalist January 12, 2009 at 9:14 am

Don’t get me started. Not only do we have to code the ICD, we have to document for CPT. We also have to document so the hospital gets paid.

The sound of silence you hear in the patient room is the lack of face time with your doctor. They are all in the other room looking up ICD codes.

2 Terri Champlin January 12, 2009 at 10:05 am

And when I get a bill for a “covered” procedures I have the complexity of those #@$ codes to blame.

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