Southern Illinois health care providers appear to be in good shape in implementing new medical coding that went into effect this month, though at a hefty price.

The new codes under the International Statistical Classification of Diseases expands the number of codes to 141,000 from 17,000 under the previous World Health Organization codes, according to the American Association of Orthopedic Surgeons.

The codes for diagnosis and procedures -- there are codes for being bitten by an orca or being pulled into a jet engine -- were last updated in the United States 35 years ago, though WHO adopted the expanded list in the early 1990s. The United States is the last industrialized country to implement what some Southern Illinois medical officials said has been a needed change.

The change went into effect Oct. 1, the point in which Medicare, Medicaid and private insurance no longer accepted previous codes. Implementation has been in the works for about three years and delayed at least twice.

The Centers for Medicare and Medicaid Services and the American Medical Association, at the request of health care providers, have been working to help providers prepare for the change.

“As we work to modernize our nation’s health care infrastructure, the coming implementation of ICD-10 will set the state for better identification of illness and earlier warning signs of epidemics, such as Ebola or flu pandemics,” CMS Acting Administrator Andy Slavitt said in a July news release.

The change has meant a roughly $2 million investment for Southern Illinois Healthcare, covering the cost of software updates, training, added staff and outsourcing to comply, said Marcia Matthias, corporate director of health information management for SIH.

A proponent of the new codes, the impact on productivity is still a concern, she said.

“There is a coder shortage, so we are paying premium dollar for extra coding support,” Matthias said.

She noted there was also concern on what impact the change would have on physicians, but she has not heard too much of a negative result from SIH doctors.

A survey by the American Health Information Management Association and the eHealth Initiatives found 38 percent of 349 providers concerned with a revenue drop because of the switch. A vast minority, six percent, said they thought revenue would increase.

Still, 40 percent of the respondents said they would be ready for end-to-end testing by the end of this year.

The CMS and AMA recognized providers needed help with the transition, jointly announcing education tools in July.

For smaller hospitals, such as Franklin Hospital in Benton that earlier this year faced a backlog of unbilled invoices because of a coding shortage, staff there has also been beefed up as a result of the backlog and in anticipation of the new regulation, CEO Hervey Davis said. He also said outside software vendors have helped with the conversion.

“We are ready for it,” Davis said.


Nick Mariano is a reporter for The Southern Illinoisan covering Saline, Franklin and Jefferson counties.

Load comments