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ICD-10: The Deadline Gets Longer

8 Oct 2014

Healthcare is in the midst of a major evolution. With the implementation of the Affordable Care Act and the technology requirements that come with it, hospital and health system CIOs are navigating enormous change.

Among those many changes happening in the healthcare environment is the pending move to a new coding system, known in its current iteration as ICD-9. Healthcare providers have been planning for the move to ICD-10 based on a hard-and-fast deadline of October 1, 2014, issued by the Centers for Medicare and Medicaid Services (CMS). Except that yesterday, Congress issued an order pushing that deadline back to October 1, 2015.

Why’s the Change Necessary to Begin With?

Healthcare providers are currently using a four-decades-old system of labeling and subsequently billing for procedures. The update is intended to allow healthcare providers to better address the more nuanced care they provide.

As an example, today there are numerous types of devices that can be implanted to address a single heart condition. One billing code is currently used to represent all of these devices. An upgrade to ICD-10 would allow doctors and health systems to better track the efficacy of a certain procedure, in addition to the other ways more detailed data can help clinicians to develop better health practices. The data for ICD-10 will ultimately be used in two ways: for insurance claims processing and statistical analysis.

Why the Emphasis on Deadlines?

The upgrade to ICD-10 has required tremendous IT effort to implement at the systems level and training throughout organizations. To add to the matter, it’s imperative that all healthcare providers move to the new coding at the same time in order to preserve continuity and avoid confusion. The extension is throwing a wrench into things for organizations who have been working toward the 2014 date.

Won’t More Time Make for a Smoother Roll-out?

For the health organizations that recalculate their timelines and factor in additional testing, more time might well make for less friction at implementation. Many smaller offices were feeling the crunch of the 2014 deadline and an additional 18 months of preparation will help ease a lot of the strain. With more smaller facilities able to comply, the goal of everyone using new coding is more likely to be realized.

This does come with two major caveats.

  1.  The CMS doesn’t have to use the October 1, 2015 deadline. They could set a date at some point beyond that.
  2. The CMS could pivot implementation toward ICD-11 standards that are currently being drafted.

The CMS has details about the ICD-10 roll-out available on their site providing updates as these regulations and revised deadlines unfold.

This was originally posted on the Insight Blog: http://blog-insight.com/icd-10-the-deadline-gets-longer/

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