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ICD-10 Delay Foments a Culture of Distrust



What does the government want? No one seems to know. It's running a race, but the finish line keeps getting moved back. As for providers, they're losing their motivation to invest in change.



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.
Don Stumpp (2/24/2012 at 1:46 PM)

You ask: "So what motivates a healthcare provider to invest? To innovate? To move forward?" In the American capitalistic society, it has got to be a Return on Investment. Some regulatory mandates can be tolerated and implemented as a cost of doing business or for the common good, but ICD-10 to a small medical practice brings no value... and only incurs expense. The incentives need to be correct, and not as the stick of 'you wont get paid" My response is then "I wont see your Medicare patients, now whatcha gonna do?" Do you think physician practices would be as far along on eRx or Meaningful Use without incentives? There are COSTS involved in the transition. What has been left out is who is paying them? Practice management systems, Clearinghouses and IT support up and down the chain are will pass the costs onto providers in higher maintenance fees, system upgrades, etc. Payers will pass on costs to their employers and members in higher premiums. Hospitals will pass on costs by higher rates back from payers (who pass it on) The physician practice has no one to pass it on to. Payers wont pay more for an office visit or EKG because you used ICD-10 code. How about Govt give an ICD-10 conversion bonus like MU? Other countries were funded by the government.
Warren Spellman (2/24/2012 at 12:34 PM)

It seems clear to many that the reason for the delay, and why no new deadline has been set, is political. The Secretary did not wish to add another controversy of hospitals not getting paid due to Medicare not being able to process ICD-10 claims (the 5010 saga by intermediaries was a small precursor to ICD-10). So once the re-election campaign of Obama is over, then the new deadline will take effect.
Patrick Plemmons (2/24/2012 at 12:11 PM)

Phil - I know what the current administration wants. They want to control every aspect of the healthcare industry so they can use it as a political tool, to reward and punish. And they want to ratchet down costs through rationing services. Simple really.