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ICD-10 Delay: Politics Trump Health Data Quality
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Mark Braunstein
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Mark Braunstein,
User Rank: Moderator
4/18/2014 | 10:50:17 AM
Re: ICD-10 different in the U.S.
Well, in theory, that's what the ICD codes are for.  In practice because claims data is so widely available and so consistent as compared to clinical data from EHRs, it is used for many secondary purposes beyond billing.  Moreover, this added detail is potentially important to payers for purposes such as spotting fraud (e.g. second amputation of the same finger).
5Tool
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5Tool,
User Rank: Strategist
4/16/2014 | 9:01:08 PM
Re: ICD-10 different in the U.S.
ICD-9 id just a diagnosis tool for insurance purposes. What do you care if the cancer is in the left or right knee? It is the same amount of money to fix it, right?
Mark Braunstein
IW Pick
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Mark Braunstein,
User Rank: Moderator
4/16/2014 | 10:57:14 AM
Re: ICD-10 different in the U.S.
I don't want to appear insensitive to the work involved but you only learn how to swim by diving in.  We need to get on with this or decide we're never going to do it (a big mistake, I think).  Some parts of the markets (providers and HIT vendors) may never take it seriously enough until its for real.  If we wait for everyone to be ready it will never happen!
David F. Carr
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David F. Carr,
User Rank: Author
4/16/2014 | 10:35:23 AM
Re: ICD-10 different in the U.S.
I think the skeptics were under-confident that they would have a "well-designed HIT tool" at their disposal as of October 1.
Mark Braunstein
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Mark Braunstein,
User Rank: Moderator
4/16/2014 | 10:03:47 AM
Re: ICD-10 different in the U.S.
I can't resist pointing out that nothing is ever "simple" in the US because our healthcare system is so overly (and I think needlessly) complex.  Having said that, here's the CMS counter argument from their ICD-10-CM/PCS Myths and Facts document I would recommend to anyone wanting more details.

"Just as an increase in the number of words in a dictionary doesn't make it more difficult to use, the greater number of codes in ICD-10-CM/PCS doesn't necessarily make it more complex to use. In fact, the greater number of codes in ICD-10-CM/PCS make it easier to find the right code. In addition, just as it isn't necessary to search the entire list of ICD-9-CM codes for the proper code, it is also not necessary to conduct searches of the entire list of ICD-10-CM/PCS codes. The Alphabetic Index and electronic coding tools will continue to facilitate proper code selection. It is anticipated that the improved structure and specificity of ICD-10-CM/PCS will facilitate the development of increasingly sophisticated electronic coding tools that will assist in faster code selection. Because ICD-10-CM/PCS is much more specific, is more clinically accurate, and uses a more logical structure, it is much easier to use than ICD-9-CM. Most physician practices use a relatively small number of diagnosis codes that are generally related to a specific type of specialty."

I'm not sure I entirely buy this but a well designed HIT tool should pretty much accomplish what CMS envisions here.


BTW, after I submitted the post a new survey came out showing that nearly 60% of health care providers are disapointed in the further delay. It sounds like the providers are tired of the drill and want to get it over with and move on.
David F. Carr
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David F. Carr,
User Rank: Author
4/16/2014 | 9:41:01 AM
ICD-10 different in the U.S.
Mark, How do you respond to the argument that the version of ICD-10 proposed for use in the U.S. is different (and much expanded) from what's been used in the rest of the world? Many of the ICD-10 skeptics I've talked with argue the U.S. added a lot of additional complexity to make the diagnosis codes work for insurance billing as well as statistical tracking.


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