It is being seen as the “Y2K” of healthcare, says Gopi Natarajan, of the imminent shift to the ICD-10 system of medical coding in the United States and the challenges and opportunities that come with it.

Y2K or the ‘Millenium Bug’ was a situation that surfaced during the turn of the century, when computer systems were unable to read or register the transition from 1999 (often written as ’99) to 2000. And this had threatened digital documentation across the world.

The ICD (International Classification of Diseases) system developed by the World Health Organisation helps document any medical condition from common cold to cancer, says Natarajan, Co-Founder and Chief Executive of Omega Healthcare.  And they are useful in gathering data, aiding healthcare management, directing resources etc.

Come October, all healthcare providers and payers in the US including hospitals, insurance companies etc are expected to shift from the existing ICD 9 to ICD 10 as it becomes mandatory. Since the US is the biggest user of the ICD coding system, the transition to the new system opens up an opportunity for certified medical coders, says Natarajan. (see info box)

Explaining why it was critical to get the coding right, he says, it also drives the reimbursement and payments system in US healthcare. Hospital bills, for example, are generated using the system.

Though ICD 10 is already operation in several countries, the US had not shifted to the new system as there are too many users, it was not easy and they were not ready, he says. Explaining the complication, Natarajan says, if ICD 9 had 16,000 codes, ICD 10 has 80,000 codes – a five-fold increase! And the level of specificity, how the coding should be done etc is complex, several business processes involved with healthcare delivery would need to change.

Every medical condition has to be coded right, as it could be disastrous if a head fracture went with a wrong reimbursement code or a head ache was incorrectly coded as a stomach ailment, he points out.

Several WHO member countries including India already use ICD 10, but unlike the US, it does not drive healthcare payments and reimbursements. The demand in the US for medical coders has increased in the run-up to the deadline, he says.

India is a critical link, as it has the most number of medical coders outside the US. And coding is the significant first step that affects payments, reimbursements etc, says Natarajan.  In fact, the AAPC (US’ largest body that trains and certifies coders) established its presence in India last year.

The US-headquartered Omega, for example, has 2000 coders and is increasing that number with another 800 to 1000 hires by March 2016, driven by the shift to ICD 10.

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