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ICD-10 Delay Alters Provider, Vendor Prep

 |  By John Commins  
   April 14, 2014

While the latest delay of ICD-10 has created some confusion, the CEO of AHIMA says providers, payers, and other stakeholders are doing what they can to prepare staff. Those that can afford it will try to teach both ICD-10 and ICD-9.

Health systems, payers and vendors aren't the only sectors in healthcare that are scrambling with the unexpected ICD-10 delay of at least one year imposed by Congress late last month.

Accrediting agencies and community colleges across the nation that were setting the curriculum and teaching the new medical coding set to about 40,000 students in anticipation of the Oct. 1, 2014 implementation have been forced to re-introduce the older ICD-9 code set. Many of those ICD-10 trainees now find their job prospects in limbo for at least a year.

The Commission on Certification for Health Informatics and Information Management announced shortly after the delay was mandated that it would hold off on testing for ICD-10 accreditation until the new coding set is "officially implemented."

"We were in good faith trying to prepare our students for the workforce that we knew was going to come about with ICD-10," says American Health Information Management Association CEO Lynne Thomas Gordon. "So instead of having our workforce ready ahead of time, which I think is better, we are saying 'now once you change it, we will test.'"

Gordon says AHIMA was ready to throw away its ICD-9 training manuals when word came down about the delay. The old manuals will be dusted off and redistributed to community colleges to help train students for the older coding set.

"They were ready for destruction that week, but fortunately we held off," Gordon says. "We are trying not to be prescriptive. We are trying to help. We are going to provide a free webinar on the difference between ICD-9 and ICD-10 to try to help. We are also going to provide a free self-assessment online for our students so that they can see how big the gap is and how much more studying they need to do to pass the credentialing exam."

Trying to Teach Both
"Is it perfect? No. I really feel for our educators who had to work hard just to get ICD-10 onto their curriculum. You should see some of the emails we got. It is so sad. They are saying they had to get it approved; they had to develop it; their educators had to go to training. Then they had to get it through their curriculum committees. They switched over in good faith. What they are saying now is they are going to try to teach both. That is tough because there is not enough time to teach both really well."

Stacey Ocander, president of the National Network of Health Career Programs in Two-year Colleges (NN2), says her organization was not surprised by the delay. "When it comes to any type of regulation coming down, especially when it comes to healthcare, we always anticipate it not happening just because it is such a volatile discipline," she says.

"There are so many stakeholders. There are the patients the families, the community, the politicians, the educators, the students, the payers and the providers and it goes on and on. So as educators we develop a curriculum where we always anticipate carrying over the old standards for at least 12 months and interweaving those in our curriculum with the chance that something will get stalled, just like it did with ICD-10."

"Our mission as community colleges," Ocander says," is to serve our communities. The last thing we want to do is get our students in a situation where they are not prepared to take that board or that registry because that is how our folks become licensed to enter the workforce."

Ocander says there will be some rough patches as students adjust to the new requirements.

"We will do study groups, some online training, tutorials. The nice thing about community colleges is we do react on a dime," she says. "We have been watching this for months. We put out notices to all of our membership, [saying] 'You need to be writing the politicians in your state letting them know this will impact our students. In the meantime, start prepping for anything you need to do you help your students prepare.'"

"That has already come out in online tutorials, the majority of which will be free for students so we are not putting a financial impact on them. These are things they can take from home and access what they need. A lot of those programs were online programs anyway, so it is not a methodology change for students."

'Stay the Course'
While the delay of at least one more year has created some confusion, Gordon says she is hearing anecdotally that many providers, payers, and other would-be ICD-10 adopters are "staying the course."

"We are hearing they are going to use this time to continue to work with their physicians on clinical documentation improvements, whether they're using ICD-9 or ICD-10. People are going to continue to do that. They are continuing to work with their vendors to get ready for ICD-10," she says.

"As far as the resources, what I heard at the CCHIIM meeting from our members in the room is that they're saying if we can afford it, we would love to continue to do dual coding. The question is can you continue to afford it? Maybe some of the larger academic medical centers and institutions can and we know that ICD-10 is better because it has more granularity and specificity. As we go to the accountable care models, you are really going to need this specificity to make sure you have healthier communities."

"I would say to providers, 'stay the course and don't take your foot off the pedal. Continue in good faith to get ready. It will come. It's just a shame it's not as soon as we thought.'"

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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