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ICD-10: Time's Up; No More Excuses

Scott Mace, for HealthLeaders Media, September 11, 2012

Jacobs is the experienced voice of reason in a corner of information technology fraught with claims and counterclaims. She is vehemently dismissive of vendors who claim to have ways to generate ICD-10 codes automatically from other coding systems. For instance, I asked her about a suggestion from the American College of Physicians that SNOMED could generate automatic ICD-10 codes from SNOMED-CP terms.

"SNOMED has about 300,000 codes, so even with ICD-10 expanding [by] 168,000 codes, you're still looking at almost double the codes SNOMED would have over ICD-10," Jacobs says. "So how are you going to accurately crosswalk 300,000 codes into 168,000 codes accurately and automatically? That's where I see the problem there. They are two different systems. They serve two different purposes, and there's double codes in SNOMED, so that's what I see as the issue with anything automated."

Another problem, according to Jacobs: Neither SNOMED nor ICD-10 group codes into a Medical Severity Diagnosis Related Group, or MS-DRG. "You'll still need coding personnel that will take the codes, even if they are somehow mapped accurately, and group them into the appropriate MS-DRG codes for reimbursement. So you're kind of looking at a clinical terminology system, a clinical tracking system, versus what you need to get a bill out the door."

One thing that bears additional scrutiny is the possibly disingenuous proposal earlier this year by the American Medical Association to study ICD-10's successor, ICD-11, with the thought of going directly to ICD-11.

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4 comments on "ICD-10: Time's Up; No More Excuses"


Dr Jeremy A Lazarus (9/14/2012 at 3:44 PM)
The article's theory regarding the AMA's opposition to ICD-10 implementation is unfounded and unsubstantiated. The true basis of the AMA's policy has already been accurately reported by HealthLeaders (http://www.healthleadersmedia.com/page-1/NRS-273412/ICD10-Cost-Timing-Concerns-Explain-AMA-Vote) and other publications when physicians passed a directive instructing the AMA to intervene on their behalf. The timing of the ICD-10 transition could not be worse. Physicians are spending significant financial and administrative resources to cope with overlapping regulatory requirements and multiple government programs that include penalties for noncompliance. At the same time, physicians face a continued threat of drastic Medicare payments cuts year after year. The mounting burdens take time away from patient care. Burdens on physician practices need to be reduced - not created - as we work to get the best value possible for the health care dollar and the nation undertakes significant payment and delivery reforms. The AMA will continue to urge the government to make good on its commitment to improve the regulatory climate for physicians. In the meantime, physicians need to understand the impact ICD-10 will have on their practices, and the AMA has devoted considerable effort to educational programs and resources to get them ready (http://www.ama-assn.org/go/ICD-10). Jeremy A. Lazarus, M.D. President, American Medical Association

Mimi Hart (9/14/2012 at 9:46 AM)
I must have missed a step..what happens under ICD-10 to the CPT system that the AMA would not be happy with?

usausa (9/12/2012 at 5:32 PM)
In the past 20 years I have headed up the coding section at 3 large hospitals, one for profit, one not for profit and now a University setting. In none of these hospitals were Physicians ready (or willing) to document to the extent ICD-10 will require and coders are NOT prepared to code to the level ICD-10 will require. It will be the unprepared leading the recalcitrant and revenues will drop like a rock. With electronic health records, Obamacare, and RACs already devastating what little revenues hospitals and physician's offices have, the smartest thing done to date was to postpone ICD-10,and that needs to be for TWO years not one. The commentators in favor of ICD-10, in my opinion, unanmously appear to benefit from the implementation in some way. Those of us who will be on the front lines can see what is going to happen, and it is our opinion that the entire medical profession(and the patients we serve) need to "Be afraid - be very afraid!"