The United States government transitioned over to a new set of insurance codes used to classify claims for adding or removing benefits. The 10th revision of the International Statistical Classification of Diseases of Related Health Problems, ICD-10, provided by the World Health Organization adds over 140,000 codes to the previous 18,000. With nearly 10 times the amount of previous classifications, the descriptions for some cases are eerily specific.
Before Oct. 1, physicians were able to opt out of the coding system so that they could focus on patients directly or provide discounts as they deemed appropriate. However, physicians working with government programs like Medicaid are restricted from providing free health care.
Although many countries have been using ICD-10 for years, they don’t use the same amount of codes that the U.S. does. The U.S. ICD-10 procedure coding system adds about 76,000 codes that are not used by other countries and a lot of them are minor modifications to existing claims. Some of them are bizarre and oddly precise for some cases. There are nine different codes that differentiate if someone was bitten by a macaw, or another variety of parrot.
According to a 2005 research study in Ohio, doctors only spend about 55 percent of their work hours attending to patients. The rest of the average physician’s time is spent on administrative tasks and filing paperwork such as insurance claims so that they can get paid. With the old insurance codes used by the outdated system of ICD-9 physicians were already jumping hoops to get paid for patient care, but now it is going to hurt patients more than ever.
The World Health Organization claims this system will help patients get the proper care they need but this only seems to provide data to insurance companies so that they can choose which claims to reject more easily. I think it will save the insurance companies’ money but waste physicians’ time with even more bureaucratic paperwork, leaving them less time to take care of actual patients.
Browsing the list of the new ICD-10 codes was an odd experience. There are 60 codes alone for rollerskating accidents, including the type of vehicle the patient collided with. Another strange set is 12 codes for alligator injuries which include being bitten, struck and crushed by an alligator. I couldn’t really find other animal codes for being crushed by a mammal or reptile but for some reason alligators seem to be a prevailing issue in the world.
The list continues beyond animals. Getting burns from water skiing is a separate code from other burn cases. A person getting injured boarding a vehicle will get different care if it’s a commercial or personal vehicle, or a dune buggy. While some cases can be remotely understandable, the list has crossed the line many times over. ICD-10 even distinguishes whether the side or bottom of a swimming pool causes an injury to a patient.
Strangely unnecessary details are described in these insurance claims to the point of a detailed crime scene investigation. Doctors are not forensic analysts and insurance claim investigators are not meant to see picture perfect details of major life events of a patient. Some codes don’t even seem to have a clear purpose for providing medical or insurance care at all. L564 is the code for polymorphous light eruption which is a true mystery for the type of insurance application it might have. Maybe someone might have an accident next to a flashlight and the doctor needs a code for it accidentally turning on.
I think that certain additions to the old classification system seem actually helpful. New types of diseases have been discovered and operating on different parts of the body might come with different levels of risk. However, the sheer amount of code additions may give doctors migraines and there are 40 different codes for that too.
Some of the new codes may seem silly or humorous, but this is a serious change to the medical industry in America and we are all affected by it. The classification system for medicine is such a time consuming social construct that it prevents doctors from doing their jobs and I think that is harmful and immoral.