Another ICD-10 Delay Could Be Costly … to Our National Security

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Original story posted on: January 19, 2015

As a company with deep roots as a government contractor focused on national security, Leidos Health supports and advocates for the Oct. 1, 2015 compliance date to transition to ICD-10-CM/PCS. Recent events have driven company representatives to speak out about a potential impact that many may be overlooking.

The purpose of this article is to revisit the “why” of ICD-10. We need to understand why ICD-10 is being implemented and how it impacts potential patients and healthcare consumers. We have fallen into the trap of working solely towards getting ICD-10 done and out of the way, since many are seeking only to finish what they have started and many more have announced that they have already tested and are ready to convert.

Above and beyond the outcries about workflow disruption, implementation costs, and the $6.8 billion estimated cost of additional delays, ICD-10 is critical to our national security. Here are some reasons why ICD-10 matters and should be implemented without further delays:

  • ICD-10 allows us to better respond to health threats such as Ebola. Ebola code assignment currently entails an ICD-9 code that it shares with other vague viral illnesses that have not been assigned a specific ICD-9 code. This makes it impossible for the U.S. to face the unknown possibilities of pandemics, epidemics, weaponized bioterrorism, and other national health threats. ICD-10 allows us to track and monitor patients with diseases similar to Ebola, because the codes are specific, the severity of illness is detailed, and we can determine illness rates as well as death rates.
  • ICD-10 enhances the United States’ ability to monitor national security. Sicknesses and plagues have become weapons in modern-day warfare. Weaponized bioterrorism is rampant in other countries. If this were to occur in the U.S., we would need a robust infrastructure for accurate and timely surveillance to monitor worsening medical conditions, levels of severity, casualties/death rates, etc. We cannot prevent, monitor, track, manage, and control what we cannot see or find. Using ICD-9 is akin to having a blind sidedue to its non-specific and sometimes missing codes and an inability to quickly create new ones.
  • ICD-10 improves patient safety and care. We cannot treat what we do not know. Some say that in general, Americans are sicker today than they were 34 years ago, when ICD-9 was first used. We can’t improve population health and create new disease prevention models if we are unable to accurately track the severity of diseases in ICD-9. Technology has made great strides since 1980, so why would we entrust our nation’s health to a coding system that is 34 years old?
  • ICD-10 codes are derived partly from physician requests. In order to keep pace with 21st-century medicine, treatment protocols, and new technological procedures, we must have a code set that can accommodate new codes. ICD-9 no longer has the capacity to add more codes for new diseases or treatment procedures. The reason for all those seemingly silly ICD-10 codes? Some providers asked for them since they actually see those types of patients — and they need the codes to do their job and to get paid for it.
  • ICD-10 is achievable. According to a recent survey, small physician practices are expected to spend between $1,900 and $6,000 to transition to the new code set. This is up for debate, since it could cost more for practices that don’t currently have computers, much less electronic medical records (EMRs). The survey can be found online at www.coalitionforICD10.org.
  • ICD-10 is manageable. Unfreeze from the panic. Physician practices do not use all 13,000 diagnosis codes available in ICD-9, nor will they be required to use or know the 68,000 codes that are in ICD-10. The majority of the additional codes are due to laterality, which is not currently available in ICD-9. ICD-10 is practice-specific, and there is no need to use or know all of them.
  • ICD-10 is the basic foundation for all electronic health record (EHR) and healthcare information technology (HIT) implementation. Without ICD-10, the return on investment in EHRs and health data exchange will be greatly diminished.
  • According to the ICD-10 Coalition, a legislative delay of ICD-10 will substantially increase total implementation costs. HIT expansion requires more systems changes, and many previously completed steps will need to be repeated. Additional delays in implementing and using the ICD-10-CM codes will also delay the move to pay for healthcare on the basis of quality and outcomes and also will diminish the consumer's ability to choose high-quality, low-cost form of healthcare.

Where can you go for help?

  • CMS offers a robust plan for physician practices to transition to ICD-10. The “Road to 10” can be found online here: http://www.roadto10.org/
  • Contact your associations: AMA, AOA, AAFP, AHIMA, AAPC, WEDI, HIMSS, and others.
  • Contact your trusted vendors for guidance, tips, and questions.

It’s time to urge the healthcare industry to consider the national security implications of delaying ICD-10. The cost of not implementing ICD-10 outweighs the cost of implementing it. The ICD-10 code sets, originally announced in January 2009, have already been delayed four times, providing plenty of time for the healthcare industry to transition. Let us not put our nation’s health and safety on hold any further.

About the Author

Juliet Santos is the ICD-10 principal for Leidos Health. Santos was formerly the senior director for HIMSS Business Centered Systems and was the EVP for the Lott QA Group. She played key roles in the creation of the ICD-10 PlayBook, ICD-10 National Pilot Program, and the ICD-10 National Testing Platform.

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Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.
Juliet A. Santos, MSN, CCRN, FNP-BC

Juliet Santos is the ICD-10 principal consultant for Leidos Health. Santos formerly was EVP of Lott QA Group and assisted with the creation of the ICD-10 PlayBook, ICD-10 National Pilot Program, and the ICD-10 National Testing Platform.