words, CMS could make submitting Medicare claims in ICD-10 optional and begin to make use of the greater detail it provides. "We would jump at that chance, in my group," says Graham.
Even before the bill passed Congress, healthcare leaders such as Cleveland Clinic CIO Martin Harris were wondering about the practicality of submitting claims in ICD-10 format to payers who are ready to accept that data. So far, it's not clear whether Medicare or any other payer would want to start accepting ICD-10 data for a fraction of new claims, which would mean supporting a mix of the two coding schemes. There will be some overlap, regardless, because unpaid claims submitted in ICD-9 format will be in circulation whenever ICD-10 goes into effect. However, it would be logistically simpler for CMS and other payers to keep the overlap to a minimum.
Regardless, healthcare IT workers interviewed were unanimous in saying it makes sense to begin collecting more detailed clinical documentation on the schedule they originally planned so they can begin generating ICD-10 codes whenever they are allowed or required. Those we spoke with worked in hospitals and health systems, rather than the smaller healthcare practices that most dreaded the transition.
"People are still lining things up, although maybe the heat and the fire is less intense," said Jaime Anand, an informatics outreach architect at UC Irvine Health. The extension of the timeline can be put to good use, she feels. "A year ago, you couldn't find enough testing people, but now there are a lot of testing people" to help prepare for the change. As with other big shifts in healthcare data management, such as the advent of medication reconciliation lists, the change, she says, "was never going to happen in a single day, overnight."
Another healthcare IT manager, who asked that his name not be used, said his firm's ICD-10 preparations are a matter of "being proactive and trying to prepare for the storm, as opposed to scrambling when it's mandated."
Alan Matsumura, a founding partner with consulting firm Sagence, said the transition to ICD-10 has been like the Y2K crisis for healthcare -- but one that won't take another thousand years to recur. "By this time, you have to be convinced that there's going to be an ICD-11," he told us. That means organizations ought to be focused on adopting "systems that are more amenable to changes over time."
Download Healthcare IT in the Obamacare Era, the InformationWeek Healthcare digital issue on the impact of new laws and regulations. Modern technology created the opportunity to restructure the healthcare industry around accountable care organizations, but IT priorities are also being driven by the shift.