ICD-10 Compliance Delay Could Be Beneficial, Article Argues

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The delay in the compliance deadline for the transition to ICD-10 code sets will be beneficial for health care organizations, according to an article published in the journal Health AffairsBecker's Hospital Review reports (Herman, Becker's Hospital Review, 3/22).

Background

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. The switch from ICD-9 to ICD-10 code sets means that health care providers and insurers will have to change out about 14,000 codes for about 69,000 codes.

In February, HHS Secretary Kathleen Sebelius announced that her agency will begin a process to delay for certain health care entities the Oct. 1, 2013, deadline for complying with ICD-10 standards. Sebelius has not indicated when the new deadline would be (iHealthBeat, 3/20).

Article Authors

The authors of the Health Affairs article are:

  • Christopher Chute, a professor of biomedical informatics at the Mayo Clinic;
  • James Ferguson, a fellow at the Kaiser Permanente Institute for Health Policy and vice president of health IT strategy at Kaiser Permanente;
  • John Halamka, chief information officer at Beth Israel Deaconess Medical Center;
  • Stanley Huff, a professor of biomedical informatics at the University of Utah and chief medical informatics officer at Intermountain Healthcare; and
  • James Walker, chief health information officer at Geisinger Health System (Conn, Modern Healthcare, 3/22).

Drawbacks of ICD-10 Transition

In the article, the authors wrote that the conversion to ICD-10 code sets will be "expensive, arduous, disruptive and of limited direct clinical benefit" (Bowman, FierceHealthIT, 3/22).

They wrote that although ICD-10 codes might help health care providers more accurately define and record certain clinical conditions, the newer codes would not be more effective than ICD-9 codes for documenting certain modern clinical data (Modern Healthcare, 3/22).

According to the authors, the ICD-10 code sets do not reflect what the medical industry has learned in the 21st century, such as the use of genetic information.

Recommendations

Instead of moving toward ICD-10 standards, the authors recommended that the health care industry move toward implementing ICD-11 code sets. They note that ICD-11 standards are closely linked with the Systematized Nomenclature of Medicine-Clinical Terms, which is a key part of the meaningful use Stage 2 criteria.

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHR systems can qualify for Medicaid and Medicare incentive payments.

The authors recommended that federal officials allow a grace period for compliance with the ICD-10 code sets or push back the compliance deadline by one to three years.

They also wrote that federal officials will need to manage the ICD-10 delay in a way that supports health care providers in the gradual shift to the ICD-11 coding system (Becker's Hospital Review, 3/22).


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