The Great ICD-10 Debate: Healthcare Coding Transforms
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.
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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.