The Great ICD-10 Debate: Healthcare Coding Transforms
April 27, 2012 08:30 AM Healthcare's move to ICD-10, an updated set of diagnosis and inpatient procedure codes, will affect everything from billing systems to medical records. After several delays, debate still rages on how to time the transition.
Why Skipping ICD-10 Would Be Worse
If you think moving from ICD-9 to ICD-10 is tough, the work would be even more burdensome for healthcare entities if the United States skipped ICD-10 and went straight to ICD-11.
That's because ICD-11 is expected to build on ICD-10. Plus, skipping ICD-10 midstream would be unfathomably unfair to those organizations that have already spent millions of dollars and many years converting their systems from ICD-9 to ICD-10.
The work that's already gone on with ICD-10 has been anything but quick and easy.
"We're not talking years, we're talking decades," said Carl Ascenzo, VP of global healthcare at Virtusa, a Westborough, Mass., IT services firm. "It's been 30 years since work started on ICD-10, and almost 20 years since the U.S. completed its version of ICD-10," said Ascenzo, pictured above. In fact, work on ICD-10 was started in 1983 by the World Health Organization and adopted by the World Health Assembly in 1992. In 1995, the United States finalized its draft of ICD-10, and compliance deadlines have been a moving target since.
Extending ICD-10 compliance to 2014 might help some organizations ensure that their clinical, billing, financial, and other systems are working properly for ICD-10, Ascenzo said. However, a delay longer than that would have been more disruptive to many organizations, he said.
"In my opinion, to do [the work] well, delay it a bit but don't stop it, we need to get this done," he said.
"Most companies take ICD-9 and put on a mapper for ICD-10 to make sure [diagnosis or procedure codes] match," he said. "The problem with that is the great expansion of codes in ICD-10, where before there might be four codes for a diagnosis, but now there might be 30 or 40," he said. "As we move forward with ICD-10, we have to make sure clinical accuracy is there as well as financial [accuracy]," in terms of codes used for reimbursement from payers, said Ascenzo, who was formerly CIO at Blue Cross Blue Shield of Massachusetts.
Also, while an ICD-11 draft by the World Health Organization is expected in 2015, it likely won't be ready for implementation for at least another five years after that--and the United States would also need to make modifications for its use here. That all would've meant even longer delays, said Ascenzo.