ICD-10 Delay Proposal: The Third Time’s Not the Charm

The road to ICD-10 has been a long and tumultuous one. The industry has already witnessed two ICD-10 implementation delays and just today we (thankfully) avoided another.  Despite a push to include a two-year delay in the recently passed continuing resolution bill, the final omnibus federal funding legislation has no provision for a delay.  Does anyone else feel like they’re experiencing ICD-10 delay-ja vu?

While a few smaller groups like the Texas AMA recently advocated for a proposed delay yet again, I’ve been pleased to see that most of the big healthcare associations have taken a firm stance against it.  Postponing the deadline at this point would wreak havoc on the U.S. healthcare system, which has invested substantial time, money and resources to prepare for ICD-10. The Centers for Medicare and Medicaid Services (CMS) has begun the end-to-end testing process, vendors have invested heavily in product and solution updates and hospitals, physicians and payers have all spent time and resources on implementation plans. Each delay imposes the need to duplicate training and education efforts, drastically increasing the cost burden on hospitals and providers.  Most of the healthcare industry has accepted that ICD-10 is here to stay, and continued uncertainty this far along in the process would impede the very important, positive momentum we have and leave behind a very expensive mess.

It’s time for the U.S. healthcare system to reap the benefits of a more efficient, patient-centric, improved code system. ICD-10 will provide more specific data than ever before, and if used in a meaningful way, this data can help improve outcomes for patients through better quality of care, increased communication and improved preventative measures. A delay would only restrain a healthcare system that’s in need of change.

The big question now is what’s next?  We dodged a bullet this time, but what’s to say there won’t be another proposed delay? The future is never completely certain, but I believe that the best vehicle for postponing the deadline again was this funding bill because it included the 2015 Health and Human Services (HHS) budget, and now that vehicle is gone. Over the weekend, House leaders stated that they would work to keep a 2015 ICD-10 implementation deadline on track, which is encouraging.  It’s possible that the new congress could take up this issue once sworn in next year, but I think it’s unlikely as they will have much bigger issues to worry about than ICD-10.

So where should we place our focus now that another delay is behind us, at least for now?  As a healthcare system, we should be focused on ensuring that the right solutions and systems are in place to support this transition without bringing workflow and productivity to a screeching halt.  There are lots of misconceptions out there about what ICD-10 is and what it isn’t, and the biggest one I see is this idea that it’s a coding problem.  ICD-10 is a documentation problem. Coders can only code what has been documented by the care providers.  Accurate and complete documentation – which is what’s being required by ICD-10 – benefits everyone from physicians and coders to patients.  ICD-10 solutions should be focused on driving accurate and complete physician documentation while maintaining workflow and productivity.

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About the Author

Dr. Robert Hitchcock

Robert Hitchcock, M.D., FACEP, is T-System’s VP and CMIO, leading the company efforts for solving regulatory issues and identifying trends. He is a nationally recognized Meaningful Use expert and active member of the HIMSS Physician Committee and other HIMSS subcommittees advocating usability and responding to regulatory issues. Dr. Hitchcock is a practicing ED physician and an Emergency Department Practice Management Association (EDPMA) board member. In 2001, he earned recognition for excellence in teaching from internal medicine residents, and in the early 2000s, he trained basic and advanced life-support EMS providers. His goal is to advance system adoption and usability to improve the quality and efficiency of ED delivery.

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