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We spend a lot of time arguing about the value of ICD-10 implementation.
Denny Flint thinks the ICD-10 debate is off the mark. The real issue is the data contained in ICD-10 codes.
There are massive changes coming in how we pay for healthcare that really has nothing to do with reimbursement codes. Those changes will be fueled by data.
So when physicians complain about how the documentation needed to assign ICD-10 codes gets in the way of healthcare and lobby against ICD-10 implementation, they’re throwing sandbags at a tsunami.
With or without all those absurd ICD-10 codes, physicians are going to have to change how they practice medicine.
As we move toward the October 2015 compliance deadline for ICD-10, the Journal of AHIMA has tackled three misconceptions about the new coding system.
ICD-9 isn’t so bad. In reality, ICD-9 is obsolete, and the longer it is in use, the more the quality of health-care data will decline, leading to faulty decisions based on inaccurate or imprecise data. This could lead to increased operating costs along with mistakes which could have a negative effect on your practice and overall billings.
More codes create confusion and difficulty. Almost half of the new codes reflect the ability to differentiate one side of a patient’s body from the other. Moreover, more codes, which are more precise, will in fact make it easier to find the right code. It’s true that it will take time to learn the new codes, but in the long-run you should see overall efficiency increase, along with more accurate medical records which will make your job easier.
We could just use SNOMED CT or move right to ICD-11. Terminologies such as SNOMED and classification systems such as ICD-10 different roles—albeit complementary ones. And, ICD-11 won’t be ready for prime time until 2017, and that dates marks the beginning, not the end, of the process toward adoption. Remember, ICD-10 was first used by World Health Organization members 1994—and 10 year’s later it’s just going live on a widespread basis.
If you would like to learn more about ICD-10 and how you can ensure that your practice is ready for the October 2015 deadline, contact us today to learn how we can help.
After months of speculation, the U.S. Department of Health and Human Services, as expected, finalized Oct. 1, 2015, as the new compliance date for providers and payers to transition to ICD-10.
An announcement from the Centers for Medicare & Medicaid Services late Thursday said that ICD-9-CM contains “outdated, obsolete terms that are inconsistent” with current medical practices, adding that ICD-10 represents “a significant change.”
“ICD-10 codes will provide better support for patient care, and improve disease management, quality measurement and analytics,” CMS Administrator Marilyn Tavenner said in a statement. “For patients under the care of multiple providers, ICD-10 can help promote care coordination.”
The transition was delayed last spring when a measure unexpectedly was dropped into legislation for a 12-month patch to the sustainable growth rate payment formula. Wording for the measure was ambiguous, stating that the HHS secretary “may not, prior to Oct. 1, 2015, adopt ICD-10 code sets as the standard for code sets.”
Ultimately, federal officials said they chose the Oct. 1, 2015, to avoid “costly” and “damaging” effects on the industry.
“For example, extending the delay beyond one year could render current ICD-10 system updates and releases obsolete, which would diminish the investments stakeholders have already made to prepare for the ICD-10 transition,” officials noted in a post to the Federal Register.
The American Health Information Management Association, in a statement emailed to FierceHealthIT, lauded the confirmation.
“Now everyone in the healthcare community has the necessary certainty to move forward with their implementation processes, including testing and training.”
Added AHIMA CEO Lynne Thomas Gordon, “As a long-time supporter of ICD-10, AHIMA is pleased that patients and other stakeholders will soon experience the benefits of a modern and robust coding system with greater specificity about diagnoses and procedures.”
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Most hospitals were ready for ICD-10 in 2014
The ICD-10 National Pilot Program is picking up steam. It’s a collaborative designed to help healthcare organizations prepare for ICD-10 testing and to share best practices. The Healthcare Information and Management Systems Society (HIMSS) and Workgroup for Electronic Data Interchange (WEDI) have taken the lead on recruiting participants and designing the end to end testing scenarios.
At the end of April, the Workgroup for Electronic Data Interchange (WEDI) and Healthcare Information and Management Systems Society (HIMSS) convened an “Emergency ICD-10 Summit” aimed at addressing the ICD-10 delay and its implications. The primary goal of the meeting was to develop a road map for the industry that offers clear guidance on implementing the code set moving forward.
The summit brought together payers, vendors, consultants, professional associations, and government agencies to share ideas and engage in productive dialogue about the delay and next steps. Out of these discussions, several key themes emerged.
Healthcare providers–and practice managers, in particular–would be wise to take advantage of the most recent ICD-10 delay, not by shifting their focus to other projects, but instead shoring up potential areas of weakness, according to family physician Stephen Spain.
“Those who have turned off the engine altogether will likely regret that decision as new deadlines approach,” says Spain in a recent post to ICD10monitor.com.
To that end, Spain suggests several recommendations to maintain momentum. Here are three:
- Ensure your vendor’s readiness: Despite the fact that the deadline has been changed multiple times, there remain some vendors that still are not ready, Spain says. Now, he says, is the time to talk with your vendor about testing and implementation plans, not this time next year. “Be sure … to hold their feet to the fire to meet deadlines,” he says.
- ID top codes ahead of time: Developing a “cheat sheet” of frequently used codes will help save massive amounts of time in the long run, Spain says. To do so, figure out which codes you use most in ICD-9, then do some digging to figure out how they’ll translate to ICD-10. “The staffer that … spearheads and implements the cheat sheet … will be the rock star of the organization after October 2015,” Spain says.
- Understand provider workflow: To ensure a smooth transition–or at least understand provider complaints about different changes–practice managers first must understand their providers’ workflow. Many electronic health record systems boast test environments, Spain says, and practice managers shouldn’t be shy about using them.
John Dugan, a partner in PricewaterhouseCoopers’ health industries practice, told FierceHealthcare in April that those in charge of ICD-10 at hospitals and practices should put together a “comprehensive training strategy,” if they haven’t already done so.
Meanwhile, Mary Beth Haugen, president of Haugen Consulting, said that healthcare organizations should seek out payers willing to do claims testing in an article published in the Journal of the American Health Information Management Association.
To learn more:
- here’s the ICD10monitor.com post
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