Updated on: March 17, 2016

Strike Three – Those Mounting Efforts to Delay ICD-10 Go Down Swinging!

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Original story posted on: December 15, 2014

Despite a significant lobbying effort mounted by a small but very vocal minority within the healthcare industry, the implementation of ICD-10 is expected to proceed without further delay.

The failed push marked a third attempt to delay the Oct. 1, 2015 ICD-10 implementation deadline well into 2017. Members of Congress rejected the request to include language that would again delay ICD-10 in the lame-duck omnibus spending bill that was passed by Congress on Dec. 11 and ratify by the Senate on Dec. 13. 

 

Failing to delay ICD-10 by using a legislative maneuver – slipping language in a massive spending bill – represents a crippling blow to opposition that will make future efforts to revisit the matter very difficult. Congress made its decision not to hold up ICD-10 after hearing opinions about it from many voices in the healthcare community, including well-organized groups of physicians. During the course of this debate, there were many myths perpetuated, not to mention promises of doom and dysfunction, but also strong cases for proceeding with the coding system upgrade.

While fans of ICD-9 will no doubt use the March 2015 sustainable growth rate (SGR) bill to make another run at delaying implementation, it will be hard to convince members of Congress that more time is needed. If Congress didn’t see the need to enact a delay in December, why would they be convinced to delay months later in March?

Advocates for ICD-10, including the American Health Information Management Association (AHIMA), national and regional hospital associations, and physician groups are applauding the decision by Congress. Across the industry, companies and healthcare organizations have invested millions of dollars preparing for ICD-10. Many physicians have planned ahead for ICD-10 by taking advantage of low- and zero-cost education resources made available by the government.

Upon hearing the news that ICD-10 cleared a major legislative hurdle, organizations issued statements expressing their support for moving forward on this long-awaited and much-needed move to implement.

“Congress issued a strong message and sent the ‘delay ICD-10’ crowd back to the bench,” said Chris Powell, CEO of Precyse, a provider of health information management solutions and staunch advocate for ICD-10.

“I predict that, in a short time, the industry will look at the upsides of a modern coding system and wish that ICD-10 had arrived much sooner,” added Powell. “The vast majority of the industry is ready to move beyond ICD-9, an antiquated and very limited system that is woefully insufficient for hospitals, physicians, and patients. We have a myriad of best practices and learnings gained from other countries’ migrations to ICD-10 before us, and we now have the green light to put ICD-10 into motion.”

Costs of Delays Adding Up

Powell and many others have pointed out the significant and measurable business damages that would result from perpetuation of ICD-9. These extend above and beyond the negative impacts of the status quo on patient care.

If future efforts to delay ICD-10 were to succeed, the cost would be measured in real dollars and could have negative implications for patient care. The U.S. Department of Health and Human Services (HHS) estimates that the cost to delay the implementation could potentially reach $6.8 billion. 

Training is just one area where delays would be a setback to thousands of employees in the coding field. Over the past few years, college and commercial medical coding training programs have sensibly stopped teaching ICD-9 in favor of ICD-10. As a result, there are legions of ICD-10-trained coders ready to put their skills to good use. Further delays to ICD-10 implementation would limit employment prospects for this important segment of the healthcare labor force.

Delaying ICD-10 will also squander the investments made in training existing personnel and preparing technology infrastructures for the new coding system. Any extension of the compliance date would result in scrapping preparation investments, and those who already began system upgrades would incur additional costs while reverting back to ICD-9.

Better Codes, Better Care

Perhaps the most compelling argument for ICD-10 is reflected in the reason medical specialty societies pushed for the new coding standard in the first place. While ICD-9 is focused on reimbursement, ICD-10 is a more precise system for assessing quality of care and tracking diagnoses for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.

The limitations of the outdated ICD-9 coding system have the very real effect of getting in the way of providing the best and most cost-effective patient care. ICD-9 is extremely limited in its ability to capture even basic patient information, such as classifying laterality and coding for severity of illnesses, which can result in payment errors and delays in payment processing.

ICD-9 also lacks the flexibility to track procedures and devices used to treat many injuries, illnesses, and conditions. Proponents of ICD-10 look forward to a day when the national picture of health trends can be fully analyzed for ways to improve care and individual patient information is more efficiently shared between caregivers.

In attempts to cast ICD-10 as unnecessarily detailed, critics have questioned coding for injuries resulting from such incidents as being sucked into jet engines. Yet for the purposes of the U.S. Department of Defense, tracking injuries to personnel working on flight operations provides important data that ICD-9 simply cannot deliver.

All other industry sectors use data to improve performance, to detect and quickly respond to trends, and to identify effective solutions – so why would anyone want to keep a limited system that provides less detail?

The majority of the healthcare industry, including those who have taken steps to get ready for ICD-10, no doubt will be pleased to get moving on the implementation of the new system. The small group of those still unprepared, however, surely are undeterred and will soon try to convince Congress that it needs another swing at a delay.

 

 

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.
Chuck Buck

Chuck Buck is the publisher of ICD10monitor and is the executive producer and program host of Talk Ten Tuesdays.