Coding déjà vu all over again

ICD-10 will be implemented Oct. 1, 2015

Marilyn Tavenner

PARCA eNews – Dec. 15, 2014 – Seems like only yesterday everyone was getting ready for ICD-10, but then last July, under pressure from health care providers who felt they could not meet the 2014 deadline, the U.S. Department of Health and Human Services (HHS) issued another extension setting a new deadline of Oct. 1, 2015.

As a result ICD-10 implementation was once again a topic at RSNA 2014 (click on subevent  MSAS21A). While much has been reported on getting ready for ICD-10, there has been relatively little coverage of what benefits ICD-10 will have for health care. 

In the press release announcing the new deadline, Marilyn Tavenner, Administrator of the Centers for Medicare & Medicaid Services (CMS) highlighted some of the reasons for implementing ICD-10. 

“ICD-10 codes will provide better support for patient care, and improve disease management, quality measurement and analytics,” said Tavenner. “For patients under the care of multiple providers, ICD-10 can help promote care coordination.”

Essentially going from some 14,000 codes under ICD-9 to the more than 69,000 codes allows greater specificity not only for providers and payers but researchers. It will improve data capture and analytics of public health surveillance and reporting, national quality reporting, research and data analysis, and provide detailed data to enhance health care delivery.

ICD-10 reflects improved diagnosis of chronic illness and identifies underlying causes, complications of disease, and conditions that contribute to the complexity of a disease. Additionally, ICD-10 captures the severity and stage of diseases such as chronic kidney disease, diabetes, and asthma. Just as important, but often overlooked, ICD-10 replaces outdated, obsolete terms that are inconsistent with current medical practice.

Depending on whom you ask, ICD-10 will either put radiologists at the mercy of referring physicians or ICD-10 will greatly aid radiologists getting complete information from referring physicians. Reimbursement for imaging services requires proof of medical necessity something that must be documented by the referring doctor beginning in 2017. Because reimbursement for referring physicians will also be dependent on documentation, using ICD-10 codes should ultimately ensure that radiologist have more complete information about a patient. 

When asked by HITECH Answers, about how organizations should approach the 2013 delay in implementation, Bonnie Cassidy, past president of AHIMA and member of the HIMSS Privacy and Security Steering Committee advised continuing preparations efforts as if there were no delay.

“Do not stop!  When the delay of the compliance date was announced, some organizations slowed down the pace and resources devoted to their ICD-10 transition plans and focused on Meaningful Use,” said Cassidy, who is senior director of HIM Innovation for Nuance. “We have found the greatest health information management success stories come from those that decided to plan as though it was still October 1, 2013.”