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.