Recently in Australia, the Independent Health and Aged Care Pricing Authority (IHACPA) announced that the classification of diseases used in Australian hospitals, ICD-10-AM now includes a new code for lipoedema. This is great news for lipoedema research and the beginning of some real help for this condition in several areas.  

In the Australian lipoedema community, it’s raised quite a few questions. Is this the same as a Medicare code? How do we use this code? Will it mean that I don’t have to pay anything for my lipoedema treatments? What kinds of things will be paid for? Do I need to tell my doctor about the code?

Let’s take a look at what ICD-10 is first. Let’s take a look at what ICD-10-AM is first. 

ICD stands for the International Classification of Diseases. It is a system codes to represent the diagnoses documented by clinicians in hospitals. 

The new code for lipoedema we are chatting about in this article has been included in ICD-10-AM Twelfth Edition which will be used by clinical coders from 1 July 2022 to record reasons for admissions to hospital, or where lipoedema is managed as a comorbidity requiring treatment or care during an unrelated admission. 

What is a clinical coder and what do they do?

Clinical coders convert information from a patient’s medical record into alphanumerical codes according to the ICD health classification system. This information then informs decision-making in relation to payment systems, service planning, administration of quality and safety, and health services research. It’s such important work and we are so fortunate to live in a day and age where this information is collected!

Why is data collection so important?

Specifically for lipoedema, data collection will improve over time but we need to remain patient and proactive when it’s appropriate so that we aren’t forgotten. The coding of medical information means that health resources can be efficiently allocated, services to help conditions can be planned, quality and safety issues around treatment can be determined, and research can be undertaken. The information needs to be collected first, then appropriate action can be taken. This is exactly what we want for best practice around lipoedema to develop!

Something you can do to improve data collection if you are being admitted to hospital, have lipoedema, and are being treated during your hospital stay, you should ensure that your discharge summary states the condition “lipoedema”. This terminology needs to be used by treating medical officers or the hospital will not be able to use the code. 

Is this ICD-10 code same as a Medicare number?

No it’s not. Medicare item numbers in Australia are a list of medical services that are subsidised by the Australian government. Medicare item numbers are completely different to the ICD codes. There is a lot of work that needs to be done before Medicare gets involved with subsidies for lipoedema, but this new ICD code is an enormous step towards that happening! Data collection first, potential government subsidies later.

How do we use this recently allocated code for Lipoedema in ICD-10?

Short answer: We don’t use this code at all.

Longer answer: The use of the code provides data that can be used by hospitals, researchers, and governments to address gaps in health services. Another good reason to ensure that your discharge summary states the condition “lipoedema”.

Should we discuss this code with our GP’s?

GP’s don’t use ICD codes. But I still think we should raise lipoedema to our GP’s when it’s an appropriate point during a consult, and I think it’s important to have lipoedema in your records if you have it.  If your GP has diagnosed you with lipoedema, ensure it is written in your medical records and spelled correctly – LIPOEDEMA. Not lipedema, not lymphoma, not lymphoedema, not lympda (yes, I’ve seen that spelling in a patient file!), not lipidemia.

It’s LIPOEDEMA.

Learn how to spell it and pronounce it yourself as well if you’re not sure!

If your doctor sends you to somebody else for diagnosis and you are diagnosed, ask for a letter to be sent back to your doctor stating that diagnosis so that it becomes part of your medical record. If a non-medical person has diagnosed you, it’s unlikely to make it to your medical file – try to get a diagnosis by a medical professional.

If you are seeking a referral for diagnosis and your GP doesn’t believe that Lipoedema exists, or tells you that you’re just fat and need to eat less and move more, THAT would be an appropriate time to get a second (or third, or fourth!) opinion.

Will this mean that I don’t have to pay anything for my lipoedema treatments?

The ICD code doesn’t mean anything in relation to government subsidy for lipoedema treatment. ICD codes are used for research purposes, not for funding or payment discussions. 

In the meantime, I highly recommend you be as proactive as possible in your own management of lipoedema. Don’t wait for things to get out of control before you take action, and don’t let life’s curve balls make you quit on yourself.

Obviously, food is a very important part of management and I recommend utilising an anti-inflammatory nutrient dense low carbohydrate or ketogenic diet. Exercise and movement can make a huge improvement to our symptoms. Compression and appropriate sequential pneumatic pumps help as well.

What kinds of things will be paid for with this code?

Short answer: Nothing.

Longer answer: At this point, nothing will change financially for us because it’s still all about data collection. But in time, now that we have this code, some things may be subsidised or rebated in the future.

All of the information included in this article is easily Googlable and I encourage you to do your own research in discovering the processes involved in getting real and tangible help for us, and for young people who are already developing the condition.

I hope this article brings some clarity to you about this development, and as always, get in touch if you need help with the nutrition side of things. I work almost exclusively with women with lipoedema and lymphoedema, and I’d be happy to have a 15 minute call with you (it’s free) to see if we’re a good fit to work together! You can book that call here https://app.simpleclinic.net/public/diary/index/gnl?service_id=5812