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10 Ways ICD-10 Will Improve Quality of Care
The popular approach to writing anything about ICD-10 conversion these days is to describe the disastrous impact providers say it will have—or is already having—on healthcare, nearly two years ahead of its launch.
From the sound of it, everyone from physicians to nurses to CFOs and CIOs must be preparing for hell itself, or at least stocking up on awesome quantities of Pepcid.
Peter Carmel, MD, president of the American Medical Association, and flocks of physician groups speak of its "onerous" burden, costing each physician $28,000, on top of the reimbursement cuts and other changes they already face.
It's another unfunded mandate with no clear benefit leading to access problems for patients, says Diane Bristol, OB-GYN legislative liaison for the Medical Group Management Association in Midland, MI.
I get it; ICD-10 means headaches, money, and time. But I write about quality, so I'm going to damn the torpedoes and talk about the whole point of this undertaking, which is, after all, to improve quality.
The decision to require the transition to ICD-10 was made years ago. Federal agencies and providers developed the U.S. version together with documentation showing that ICD-10 code sets will improve our understanding of why we get sick and how we give care.
ICD-10 will increase the number of procedure codes from 4,000 to 72,000, and the number of diagnosis codes from 14,000 to 69,000. Sue Bowman, one of several ICD-10 cognoscenti who shared her expertise with me, says most physician practices will use only a small set of these codes, so it's really not so draconian.
So tune out all the sobbing, screaming, and procrastinating and focus on 10 reasons why ICD-10 will prove to be a good thing, eventually:
1. Updates to current terminology and specificity
ICD-9 was developed in 1979, a time when terms like laparoscopic, endoscopic or thoracoscopic were unheard of in surgical suites. "Our ICD-9 system is ancient," says Bowman. Take the structure of disease management codes for asthma, she says. "It's either intrinsic or extrinsic asthma, which doesn't match the clinical classification currently in use, that is persistent, or intermittent," or any number of other types.
"When you think about the fact that this system is now over 30 years old, and you think of the state of medicine in the 1970s... you realize it's not surprising that there's a lot of these problems (within ICD-9) that structurally just can't be fixed," she says.
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Comments are moderated. Please be patient.
ralph (2/17/2012 at 12:48 PM)
I'm trying to understand how going from 14,000 CPT billing codes to 140,000 ICD-10 billing codes improves quality of medicine? It might improve the quality of live of bean counters who have to sort through this mess, but thats it. Thats why at www.medibid.com there are no billing codes, and patients save about 80% off of the billed rates
patient advocate (12/2/2011 at 2:30 PM)
Physician practices are provided with a substantial amount of money to ease the burden of modernizing their practice to use EHRs, and transitioning to ICD10 is certainly part of that. A $40,000+ investment by American tax payers that is available to all physicians that adopt new HIT technologies is a far cry from "and do it all at my own costs".
Dr. Nathan (12/2/2011 at 11:01 AM)
The transition to ICD-10 in other countries will not parallel the experience of the U.S. The main difference is that other countries adopted versions of ICD-10 that had much fewer codes. Physicians in the U.S. are required to fund a transition that will be far more complex and difficult than in any other country due to our multipayer health care system. In addition, other countries offered government funding to offset implementation costs. Other countries also eased their health care systems through the transition by implementing ICD-10 in phases or in specific settings. It seems the only ones who are optimistic about ICD-10 are the hospitals and their consultants who are dreaming up expanded billing schemes. Physicians shouldn't be expected to carry a disproportionate burden of the ICD-10 investment costs when others will be the primary financial beneficiaries.