Codes showing the diagnoses of a patient?s illnesses could help slow down increases in the cost of health care ? but they must be implemented first, an insurer said last week.

Vice president of group insurance at Argus Cindy Campbell said the diagnostic codes were always intended to be implemented as a second phase following the implementation of the CPT codes (current procedural terminology codes) in Bermuda in 2002.

The CPT codes, she explained, are compiled by the American Medical Association. Basically, the code gives a comprehensive definition of medical procedures, and then provides a guide defining what reimbursement should be given for those procedures.

The CPT codes are taken to a local fee analyser, who converts them to fees for Bermuda. The fee is what the physician charges; insurers usually reimburse a percentage of that fee based on a pre-negotiated contract.

That, however, is an overly-simplified explanation of the CPT codes.

Ms Campbell explained that in 2002 it was felt implementing CPT codes and diagnostic codes would need to be separated into two steps to allow the medical community time to adjust to each one.

With 2005 approaching, the time has come to begin work on diagnostic codes. While CPT codes show which medical procedures were done, diagnostic codes show what the diagnosis of a patient?s ailment was ? in other words, what illness/injury they were suffering from.

That information is important statistically, allowing information to be gathered about a population?s health. Currently Bermuda has very little in the way of health statistics, which, if gathered, could help pinpoint which health problems should be targeted on the Island and eventually help slow down the cost of health care.

Diagnostic codes would also aid insurers, allowing them to verify that the services and procedures done on a patient are relevant to the diagnosis. However: ?No one is taking action, not Government or the insurers,? Ms Campbell said.

The codes do not necessarily need to be legislated, therefore it is not just Government which must take a leadership role, she added. ?It would have to take the stakeholders ? the physicians, the insurers, and Government ? everyone together. It will take the co-operation of all.?