Diagnostic codes are a shorthand method for doctors and insurance providers to communicate. Each disease has a diagnostic code. The doctor gives the health insurer the code to receive the reimbursement.
Health insurance companies will only reimburse certain tests for a specific medical condition. For example, a doctor would not be reimbursed for a chest X-ray on a patient who had a broken leg. Using a diagnostic code simplifies the billing and refund process.
Diagnostic codes are listed as CID9 or CID10. ICD is an acronym for International Classification of Diseases and the numbers nine or ten make it clear which version of the ICD code is being used. Many medical practices still use ICD9, but will eventually move to ICD10.
ICD diagnostic codes are updated as more is learned about a disease. Code numbers are not randomly assigned; instead, similar diseases are grouped together. So, for example, if in the past a certain medical illness was considered a psychiatric condition, but now we know it is a neurological condition, the condition would need to be reclassified.
There are several reasons why you might want to know more about diagnostic codes. Reviewing the documentation submitted by your health insurance provider may give you access to the codes your doctor has entered in your medical record. This official classification can answer questions you may have about an undiagnosed medical condition. By understanding the codes, you will learn what your doctor is looking for.
Even if you are not experiencing any health conditions, it makes sense to review the documentation submitted by your health insurance provider. If the diagnostic codes are not related to any tests or conditions you have, you could be a victim of medical identity theft. In a world where more people are uninsured, medical identity theft is a growing problem.
While medical identity theft may seem like less of a problem than traditional identity theft, it can have just as much of an impact on your credit. One of the main reasons people file for bankruptcy is due to outstanding medical bills. If someone uses your identity to get medical care, you could quickly find yourself under a mountain of bills, no matter how good your insurance plan is.