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When I began studying the ICD-10 code structure for my specialty, otolaryngology (ear, nose, and throat, or ENT), I was shocked.ICD-10 codes are indeed increased in number from ICD-9, but there is absolutely no rhyme or reason to the expansion. For some diagnoses, such as vocal cord paralysis, it is critical to identify which side is paralyzed.Although those of us in ENT medicine have yet to find any left/right differences in ear pathology, one could argue that with better data collection, maybe we’ll discover something new. How can we gather any useful data from such a haphazard coding system? The supporters of ICD-10 seem to think that once the system is in place and petabytes of data are collected, medical advances will just fall from the sky. It is true that the current system and its structure lack the capacity to hold enough codes to cover all known diagnoses, but it could have been easily been modified and expanded to accommodate more diagnoses and increasing medical knowledge without rendering existing codes obsolete.If that’s the case, then similar logic would assume that all ICD-10 codes for ENT are divided into left and right. Beyond codes for ear diagnoses, almost nothing is coded by side. A completely new coding system was conceived because bureaucrats and academicians fancy themselves worthy of conscripting the rest of us into uncompensated data collection, and IT vendors will make a handsome profit.Over the years, an entire industry has sprung up dedicated solely to medical coding.The number of codes has increased from about 15,000 to almost 70,000, and no code that appears in ICD-9 is valid in ICD-10.But October 1, 2015, could also bring complete chaos to the health care system—with those who have allowed this system to be mandated to blame.It won’t be long before we see where the chips are going to fall.

Medical coding is complex and has no room for error (I know; it’s what I do).

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Decades of coding experience will be carelessly tossed out the window, leaving many doctors to spend precious time figuring the new system out rather than actually treating their patients.

Supporters of ICD-10 (insurance companies, bureaucrats, health IT vendors, and academics) assure us doctors that it is worth the sacrifice.




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