As a Florida Personal Injury attorney whom has represented thousands of auto accident injury clients over a 20 year period, I have seen many changes in the way my clients injuries are documented in medical records. One thing they do not teach you in law school is the need to decipher medical codes when working to collect losses for a client injured as a result of the negligence of another.
So what are medical codes, and where did they come from? Medical codes have been around since the 1960s, with the Current Procedural Terminology (CPT) listing developed as a type of “shorthand” for medical providers to document the findings of a patient. As stated by the American Medical Association (AMA), “The purpose of CPT is to provide a uniform language that accurately describes medical, surgical, and diagnosis services, and thereby serves as an effective means for reliable nationwide communication among physicians and other healthcare providers, patents, and third parties.”
In years past, personal injury attorneys had the luxury of doing a thorough review of medical record summaries to determine the findings and diagnosis of a client’s condition. For many years, however, Florida injury attorneys have had to improve their knowledge of CPT codes for a couple of reasons. First, it is imperative when representing a victim of automobile accident injuries to be sure that an important diagnostic finding is not “buried” in a CPT code. Secondly, the Florida legislature has made changes to such things as the Personal Injury Protection (PIP) laws that affect the amount of benefits an injury client can receive by tying payment to various medical codes and Medicare schedules.
So how does the World Health Organization (WHO) fit into all this? WHO has it’s own classification list of medical codes called the International Statistical Classification of Diseases and Related Health Problems (ICD). The United States has used the ICD-9 for years to facilitate Medicare and Medicaid billing. Several years ago, the United States was to adopt the new ICD-10, but there is significant controversy over implementing this new system of codes. Depending on which article you read, some would claim that the ICD-10 will create over 170,000 codes including sub-codes, and the AMA has estimated that physicians with even small family practices could be hit with an economic impact of up to $250,000 to achieve compliance.
ICD-10 for HIPPA providers was to start on October 14, 2014. However, that has been delayed an additional year, and now has an affective date of October 1, 2015.
These ongoing changes to CPT and ICD codes will continue to be big issues for Florida personal injury attorneys as well. As new codes are implemented, it will be important to properly analyze medical records, and make sure that an important diagnostic finding is not buried in a billing code.
As an experienced New Port Richey Florida personal injury attorney with twenty years experience representing clients injured in automobile accidents, I understand the need to closely review medical records. Prior to becoming an attorney I worked in the medical field, treating the acutely injured as a Florida State certified Paramedic/Firefighter. If you have been injured in an automobile accident, call today for a free consultation.
