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ICD-10: The Time Has Arrived

2 Oct 2015 by Insight Editor

The time has come for healthcare providers to step up to the plate. Healthcare’s newest evolution has finally begun. As of Oct. 1, healthcare providers are expected to start using new codes to define illnesses or injuries.

However, according to WEDI’s ICD-10 survey results, less than 50% of physician practices responded they were ready to transition to ICD-10 by the Oct. 1 date. After several delays, the tens of thousands of new codes are coming nearly two years later than expected.

Think remembering the original 14,000 codes was difficult? Think again. Providers now need to remember 68,000 codes. Instead of just inputting “broken leg” into the system, it must be specified where on the leg the break happen, where the patient was at the time of the accident, and much more.

What was wrong with ICD-9?

Healthcare providers were using a four-decades-old system of labeling, and subsequently billing, for procedures. ICD-10 is intended to allow healthcare providers to better address the more nuanced care they provide.

As an example, today there are numerous types of devices that can be implanted to address a single heart condition. ICD-9 used to represent all of these devices. Now, ICD-10 will allow doctors and healthcare providers to better track the efficacy of a certain procedure and more detailed data can help clinicians develop better healthcare practices. The data for ICD-10 will ultimately be used in two ways: insurance claims processing and statistical analysis.

Why the delay?

Congress originally wanted the new system adopted in October of 2013, but many concerned industry groups requested more time to prepare, so in September of 2012 Congress changed the date to October 1, 2014.

In April, the President signed the Protecting Access to Medicare Act of 2014. The law is intended to provide a temporary fix to the Sustainable Growth Rate (SGR) for physician payments. Section 212 of the law stops the Secretary of Health and Human Service from adopting the coding system prior to October 1, 2015.

In its publication of a final rule, the Centers for Medicare and Medicaid Services estimated that the costs of a one year delay to the entire health industry range between $1 billion to $6.6 billion dollars. This is between 10–30% of the money that has already been invested or budgeted.

Why the emphasis on deadlines?

The upgrade to ICD-10 required tremendous IT effort to implement at the systems level and training throughout organizations. To add to the matter, it’s imperative that all healthcare providers move to the new coding at the same time in order to preserve continuity and avoid confusion.

Want to brush up on your ICD-10 codes? Follow @EveryICD10 on Twitter who will tweet all of the ICD-10 codes.

Read about why the original deadline got extended and how practitioners reacted