ICD-10 Delay – What Do We Do Now?

Kathy McCoy, MBA May 16th, 2012

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What if every air traveler coming to the US had to transfer to an antique aircraft before entering American airspace because our systems were not compatible internationally? As we continue to use ICD-9 in an ICD-10 world, coding of contemporary health data presents a similar dilemma.

Delaying the Delayed

ICD-10 expands by thousands the number of medical diagnosis and in-patient procedure codes used for clinical, billing, and financial systems of healthcare providers, payers, and other covered entities, thereby allowing much greater specificity in coding and later research. The U.S. is the last major country in the world that has not yet fully implemented ICD-10. On April 9, 2011, Health and Human Services proposed a shift in its deadline for implementation of ICD-10 from October 1, 2013 to October 1, 2014. (Note: Comments on the proposed rule that would delay the compliance date for ICD-10 from 2013 to 2014 are due to HHS no later than 5 p.m. eastern time May 17.) This is the second time in three years that HHS has delayed its implementation of the new code sets. And as of Tuesday, the AMA is urging CMS to further extend the ICD-10 deadline at a minimum to Oct. 1, 2015.

While some may bemoan the high costs for conversion to ICD-10, most understand that the conversion must happen. ICD-9 has been in use since the mid-1970s and was not designed for the current medical/technological environment. Implementation of ICD-10 will bring greater coding accuracy, higher quality health information and even better care.

There’s One Path

But would it be better to wait for ICD-11, scheduled for delivery to the World Health Assembly for official endorsement in 2015? Sue Bowman, director of coding policy and compliance for the American Health Information Management Association, says no. “ICD-10 is the pathway to ICD-11,” she said. “You have to treat it like you’re building a structure starting with a first floor. You can’t build a fourth one without constructing a second and third.”

Implementation of ICD-10 is a long time coming. In a related blog post, Rhonda Butler, senior clinical research analyst with 3M Health Information Systems, said, “Unless we willfully ignore our own human nature, we should expect the same slow-mo street fight to implement ICD-11, lasting roughly two decades.” Rhonda continued, “Let’s go ahead and implement ICD-10 in 2013 or 2014, and decide now to implement ICD-11 in 2024. Planning now for ICD-11 would have the added benefit of establishing a new expectation in the industry—that regular upgrades to any system that facilitates the exchange of data is normal and expected.”

Positive Signs

We may be further along than many think. In a recent poll sponsored by the ICD-10 Watch blog, only 5% of respondents said that they need the additional year to implement ICD-10. A heartening 82% of all respondents said that they could use the extension but feel that they would have made the 2013 deadline. Only 9% stated that they need two more years to finish conversion.

Plan Now

So what’s the bottom line? Don’t let the new deadline allow you to put off your ICD-10 implementation work. Kareo encourages you to think ahead and plan for the ICD-10 transition on October 1, 2014.


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