Editor's note: The Department of Health and Human Services (HHS) announced on April 9 a proposed rule that would delay, from October 1, 2013, to October 1, 2014, the compliance date for the International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10).
Think the industry is better off delaying ICD-10 even further or jumping to ICD-11 instead? Think again.
1. It enhances quality measures. Without ICD-10 data, serious gaps will remain in the healthcare community's ability to extract important patient health information needed for physicians and others to measure quality care.
2. Research capabilities will improve patient care. Data could be used in a more meaningful way to enable better understanding of complications, better design of clinically robust algorithms and better tracking of the outcomes of care. Greater detail offers the ability to discover previously unrecognized relationships or uncover phenomena such as incipient epidemics early.
3. Significant progress has already been made. For several years, hospitals and healthcare systems, health plans, vendors and academic institutions have been preparing in good faith to put systems in place to transition to ICD-10. A delay would cause an unnecessary setback.
4. Education programs are under way. To ready the next generation of HIM professionals, academic institutions have set their curriculum for two-year, four-year and graduate programs to include ICD-10.
5. Other healthcare initiatives need ICD-10. ICD-10 is the foundation needed to support other national healthcare initiatives such as meaningful use, value-based purchasing, payment reform, quality reporting and accountable care organizations (ACOs). Electronic health record systems being adopted today are ICD-10 compatible. Without ICD-10, the value of these other efforts is greatly diminished.
6. It reduces fraud. With ICD-10, the detail of health procedures will be easier to track, reducing opportunities for unscrupulous practitioners to cheat the system.
7. It promotes cost effectiveness. More accurate information will reduce waste, lead to more accurate reimbursement and help ensure that healthcare dollars are used efficiently.
If ICD-10 is delayed:
8. Resources will be lost. For the last three years, the healthcare community has invested millions of dollars analyzing their systems, aligning resources and training staff for the ICD-10 transition.
9. Costs will increase. A delay will cause increased implementation costs, as many healthcare providers and health plans will need to maintain two systems (ICD-9 and ICD-10). Delaying ICD-10 increases the cost of keeping personnel trained and prepared for the transition. Other systems, business processes and operational elements will need upgrading also. More resources will be needed to repeat some implementation activities if ICD-10 is delayed.
10. Jobs will be lost. To prepare for the transition, many hospitals and healthcare providers have hired additional staff whose jobs will be affected If ICD-10 is delayed.
And finally …
We can't wait for ICD-11. The foundations of ICD-11 rest on ICD-10, and the foundation must be laid before a solid structure can be built. ICD-11 will require the development and integration of a new clinical modification system. Even under ideal circumstances, ICD-11 is still several years away from being ready for implementation in the United States.
For more information, go to www.ahima.org/icd10/default.aspx.