On Oct. 1, the federal government ordered doctors to use 124,000 new billing codes. Local medical office administrators find the requirement burdensome, costly and it takes time away from patients.

CRESTVIEW — If someone is burned when his water skis burst into flames, the government has a code for the injury.

An index of more than 142,000 medical codes — many of them covering rare situations like this one — went into affect Oct. 1, and it’s causing headaches at local doctors’ offices.

‘IT’S RIDICULOUS’

Coding patients’ ailments isn’t new, said licensed practical nurse Amy Herf, Crestview’s Peoples’ Home Health representative. The World Health Organization implemented The International Classification of Diseases, or ICD, in 1979, she said.

But ICD-10, the system’s 10th revision, which the Centers for Medicare and Medicaid Services implemented Oct. 1, increased ICD-9’s 14,000 disease codes to around 70,000. Medical procedure codes rose from 4,000 to about 72,000, according to Tech Times' website.

“It’s like being told you have to learn a new language to do your job,” Amy Herf said.

The plethora of new codes has swamped medical practices throughout the area.

“It’s ridiculous,” said nurse Betty Jordan, who manages Crestview general practitioner Dr. Abdul Mir’s office. “It requires so much extra work. If my doctor treated someone for rheumatoid arthritis, there’s hundreds of codes. It’s got to be specific.”

“It’s really, really detailed,” Andrew Linares, an administrator at Dr. David Herf’s office, said. “Instead of just saying, ‘cyst of the arm or trunk,’ you have to get really specific.”

“If it is one digit off, it could change the diagnoses from a broken finger to a fractured toe,” Amy Herf said.

The paperwork increase is particularly burdensome for general practitioners like Mir, whose patients consult him for a wide variety of causes.

“It is horrible for a primary care doctor,” Jordan said. “For a specialist, they deal with the same things over and over. For us in family practice, we see all kinds of things. It’s overwhelming.”

FINANCIAL IMPACT

Another aspect of the new codes also affects medical offices.

“It’s directly related to revenue,” Amy Herf said. “If you bill wrong, you don’t get paid.”

“If we don’t file a claim properly, and get rejected, it affects our income,” Patti Bonta, Mir’s front office manager, said.

Large practices and medical companies, such as Peoples’ Home Health, usually have coders on staff. Their only job is to enter the numbers into billing records and insurance reimbursement forms.

For smaller offices like Dr. Herf’s and Mir’s, the increased coding tasks take away staffers’ time with patients.

“We’re an old-fashioned small office that still answers our phones, calls messages back and tries to be personable to the patients,” Jordan, who’s worked 35 years for Mir, said. “ICD-10 takes that time away from us.”

TECHNOLOGY ADVANTAGE

Not all doctors’ administrators find adapting to the new codes as difficult as others.

Younger staffers, who are used to ever-evolving technology, have adapted better, Amy Herf said.

Linares, 23, said despite the influx of codes, he finds the new system going relatively smoothly. Updated office software guides him through the new codes.

“Luckily, they built in some help,” he said, demonstrating how the software brings up a selection of new codes when Linares enters the older code with which he is familiar.

Through webinars and training classes since August, some doctors’ offices find that adopting the new codes is slowly becoming less of a struggle.

 “We got some glitches out of our system. I think we’re on the right path now,” Bonta said.

“It’s like when your iPhone upgrades,” Linares said. “There’s still some bugs in it.”

So when it comes time to enter code V91.07XA — “burn due to water skis on fire" — or Z63.1 — “problems in relationship with in-laws" — local doctors’ offices are ready.