c.2013 New York Times News Service

c.2013 New York Times News Service

Know someone who drowned from jumping off burning water skis? Well, there’s a new medical billing code for that.

Been injured in a spacecraft? There’s a new code for that, too.

Starting next year, a transformation is coming to the arcane world of medical billing. Overnight, virtually the entire health care system — Medicare, Medicaid, private insurers, hospitals, doctors and various middlemen — will switch to a new set of computerized codes used for determining what ailments patients have and how much they and their insurers should pay for a specific treatment.

The changes are unrelated to the Obama administration’s the new health care law. But given the lurching start of the federal health insurance website, HealthCare.gov, some doctors and health care information technology specialists fear major disruptions to health care delivery if the new coding system — also heavily computer-reliant — is not put in place properly. They are pushing for a delay of the scheduled start date of Oct. 1 — or at least more testing beforehand.

“If you don’t code properly, you don’t get paid,” said Dr. W. Jeff Terry, a urologist in Mobile, Ala., who is one of those who thinks staffs and computer systems, particularly in small medical practices, will not be ready in time. “It’s going to put a lot of doctors out of business.”

The new set of codes, known as ICD-10, allows for much greater detail than the existing set, ICD-9, in describing illnesses, injuries and treatment procedures. That could allow for improved tracking of public health threats and trends, and better analysis of the effectiveness of various treatments.

Officials at the Centers for Medicare and Medicaid Services declined to be interviewed about the new codes. But a spokeswoman said that the agency was “committed to implementing ICD-10 on Oct. 1, 2014, and that will not change.”

Still, the troubles with HealthCare.gov have given new ammunition to those urging a go-slow approach on ICD-10 and have made it harder for the government to stand behind assurances that the transition will go smoothly.

“I think that people at CMS understand the stakes with respect to ICD-10 in a heightened way as a result of HealthCare.gov,” said Linda E. Fishman, senior vice president for policy at the American Hospital Association.