Medical alert: Diagnostic codes undergoing sea change!


Beginning October 1, the claims that a medical provider files on your behalf to get paid could be going dark in a no man’s land of medical billing snafus.

Major change of the ICD is upon us

Have you ever gotten those statements in your e-mail or in the mail called EOBs (estimation of benefits)? Most people ignore those things. But I look at them closely. I want to be sure everything has been billed correctly; I don’t really understand what I’m looking at, but I just look for anything that’s really gone awry.  

Read more: How to decide if an HSA is right for you

But here’s the rub: There’s a new slate of diagnostic codes providers will have to enter tobe  reimbursed under the revamped International Classification of Diseases. The change is positively Byzantine; just to give you an idea, we’re going from 14,000 codes a doctor’s office could potentially enter to 70,000, according to The Wall Street Journal!

The reality is that most doctor’s offices are not ready for this change. So expect a lot of bills to be kicked back to you unpaid while we go through this massive transition. You’re going to have to be your own advocate with billing particularly over the next few months.

Here’s the most important thing to know: If you get a statement from your insurer saying you’re responsible for the bill, call the doctor’s office and say, ‘They rejected what you did for me. Does the bill need to be recoded?’

Recoded is the key word you need to throw out there. Hopefully they’ll get it right the second time!

Read more: The best way to control your blood pressure without medication

For more money-saving advice, see our Health section.

  • Show Comments Hide Comments