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ICD-10 Delay Foments a Culture of Distrust

Philip Betbeze, for HealthLeaders Media, February 24, 2012

What hasn't been said about the "surprise" decision by the Department of Health and Human Services to extend the existing Oct. 10, 2013, ICD-10 implementation deadline?

Well how about this: Despite the fact that the decision may allow a few organizations more time to meet the deadline, the bigger danger is that it will set back the pace of what many feel is a sorely needed, radical makeover of the healthcare system so that it becomes more transparent, safer, and more fraud-resistant.

Not that ICD-10 implementation by itself will achieve transparency, relief from high costs, and poor quality. It won't. Not by itself, that is.

As you already know, ICD-10 is essentially a coding system that costs a lot to implement, and the returns from using it will largely accrue to payers, according to some. Indeed one of the benefits of the new coding regime, although it's supposed to be revenue-neutral, is that it will be a tool for improved healthcare cost control.

On the other side, there are those who argue convincingly that over time, ICD-10 could improve payment accuracy, allow providers to anticipate higher patient volumes, and deliver reams of data that will help improve quality of care

But what's particularly worrying about last week's announcement that ICD-10 implementation will be delayed is the fact that many, if not most, significant healthcare groups are actually opposed extending the deadline. That might be a first.

Comments are moderated. Please be patient.

6 comments on "ICD-10 Delay Foments a Culture of Distrust"


Dave W. (3/20/2012 at 9:27 AM)
I think many people have overestimated the financial impact of ICD-10 on physicians. For starters, not all physicians use every single code in the ICD-9 book outside of, say, a trauma center. In your standard office setting, I would be amazed if a majority of physicians used every single ICD-9 code in the book. What usually happens is that practices will isolate just those codes that apply to them. The rest is understanding how the structure works so that if a less common code needs to be used, you know how to find it. I fail to see how with ICD-10 would change that practice. Additionally, when a physician is dealing directly with a patient, ICD-10 still changes nothing if they're observing best practices for their medical notes. ICD-10 codes offer greater specificity for any condition like severity and laterality. If a physician is already detailing all of those down in their notes, how will that change? If they are not taking those items into account, then why aren't they? If anything, ICD-10 serves as a reminder of best practices when a physician is dealing with a patient and dealing with their own practice.

Texas Medical Association (2/27/2012 at 10:33 AM)
What this writer leaves out is the one major group opposed to the old deadline: physicians, without whom this great tool won't work. This is just too big of a change at a time when so many other changes are being forced on hundreds of thousands of physician practices that don't have and can't afford the infrastructure that the big players have to make this happen. The delay was absolutely the right thing to do.

Chris Taylor (2/25/2012 at 2:38 PM)
At HIMSS 2012 this week in Las Vegas and this was the common topic of discussion (other than EMR lack of usability). The ICD-10 delay should be seen less as a chance to put off focus than an opportunity to get ahead of the enormous changes that have little to do with the 'translation'. Trading partners are going to need to come to agreements on how to code accurately and in a way that makes sense for both parties. This is a level of collaboration that hasn't existed before. Many companies talk about training underway for staff, but are they addressing ICD-10's need for knowledge of anatomy, pathology, etc.? There is significant risk that the staff that currently code can't simply be trained. Lastly, this change creates process challenges that, unless addressed, will add to the chaos of the change. It will be interesting to see who understands this and who doesn't.