The upcoming October ICD-10 deadline has many healthcare professionals scrambling to ensure their systems are up-to-date for the new coding system. ICD-10 poses concerns about loss of productivity and readiness, but soon the coding system will be the new norm for healthcare facilities around the United States.
Here are 10 things to know about ICD-10:
1. Many facilities are concerned whether payers will be up-to-date with the new codes. The ICD-9 codes are between three and five digits while ICD-10 codes are between three and seven digits, amounting to a 40 percent increase in keystroke volume. ICD-10 consists of approximately 68,000 codes. Many facilities should inventory their insurance payers to ensure they are accepting the new codes.
2. The majority of providers are not prepared for the ICD-10 transition. An ICD-10 physician readiness poll revealed 62 percent of physicians are not prepared for the ICD-10 transition, according to Medical Economics. Those participants who stated they were not ready for the transition attributed a lack of time and an increase in cost as well as physician and staff buy-in as barriers to being ready.
Approximately 28 percent of participants cited training cost and/or time as a roadblock to ICD-10 preparation. Physicians also cited cash flow issues as a challenge.
3. Policy makers allowed for a six month grace period in which providers will not be penalized for coding errors. Dual coding, however, can have costly ramifications. Combining ICD-9 and ICD-10 codes will damage CMS quality, demonstration and risk-adjustment programs. The delay will be costly for payment reform, public health, healthcare delivery innovation and healthcare spending. A one-year delay is estimated to cost the healthcare industry approximately $6.8 billion dollars.
4. While many opponents of ICD-10 pushed for the delay to ensure facilities are ready, many healthcare professionals are equally against the delay. According to a recent poll surveying 1,000 healthcare professionals, approximately 58 percent were disappointed by ICD-10's 2014 recent delay. Students also are impacted by the delay as many medical students have been learning to code exclusively using ICD-10. With 40,000 scholars and current professionals studying at community colleges and going through accreditation programs teaching ICD-10, the delay is a great disservice to these individuals.
5. ICD-10 experts highly advise healthcare providers to partake in substantial training in ICD-10 to minimize associated loss in productivity in costs. However, a recent time study published in the Journal Perspective in Health Information Management stated even the highly trained providers will take 54.4 percent longer with the new coding system. Additionally, estimates of productivity loss typically lay somewhere between 30 percent and 50 percent. On average, ICD-10 coding will take 69 percent longer overall.
6. ICD-11 is expected be released in 2017, with revisions already underway on ICD-10. European countries have been using ICD-10 since the 1980s. The American Health Information Management Association states that the United States is "is the only industrialized nation not using an ICD-10-based classification system for morbidity reporting." While ICD-11 is in the works, the United States cannot simply skip from ICD-10 to ICD-11. The healthcare system must follow the progression from ICD-9 to ICD-10.
7 The World Health Organization no longer supports ICD-9, making ICD-10 implementation long overdue for the United States. ICD-10 currently is the international standard for reporting and monitoring disease and mortality across the global. The discrepancy in coding system makes it difficult to quantify worldwide statistics on cases of pandemics and other world issues.
8. ICD-10 has an influx of new codes that seem to cover any medical injury possible. Some of the codes are quite humorous.
Some of the more ludicrous codes include:
• W16.221- Falling into a bucket of water, resulting in drowning and submersion.
• 7. Z63. 1- Problems in relationship with in-laws.
• V9733xD- Sucked into jet engine, subsequent encounter.
• Y92.72- Injured in a chicken coop
• W22.02XS- Walked into lamppost
9. All codes in ICD-10 begin with a letter and every letter is used with the exception of "U." The majority of the 3-digit diagnostic code categories are composed of a letter followed by two numbers, yet there are exceptions such as code M1a, the code for chronic gout.
10. The American Hospital Association surveyed hospital members on how ready they were for ICD-10 implementation. Of the approximately 1,000 hospital members surveyed, approximately 41.8 percent reported having an ICD-10 implementation plan. A mere one percent of hospital members stated they were completely ready for ICD-10 implementation, with 60.1 percent stating they were underway and on track for implementation.
Participants cited three competing priorities posing challenges for ICD-10 implementation. These include:
• Other health initiatives (electronic health records): 51.5 percent
• Quality reporting: 26.8 percent
• Prior capital projects: 21.7 percent