Electronic Health Reporter

Guest post by Michele Hibbert-Iacobacci, vice president of information management and client services, Mitchell International.

Seamlessly integrate ICD-10? How is that possible? Realistically, yes, ICD-10 is new and the United States will start to utilize the new code set effective October 1, 2014.

Is ICD-10 really new, though? Not really, and frankly many entities are so ready they are looking forward to ICD-11, which has a “who knows when” implementation timeframe.

Seamless integration of anything takes preparation. The best part of ICD-10 is that covered entities have started and stopped implementations twice prior to the impending October 1, 2014 effective date. In fact, we almost had a third postponement with proposed federal legislation called the “Costly Codes Act,” which today has a two percent chance of making it to committee and zero percent chance of passing. This bill has more than 35 sponsors, so it’s amazing that we are seven months from implementation and this type of delay is still being contemplated.

It’s likely the sponsors are not aware of where ICD-10 has been and where it is going. The 2014 implementation date was postponed because of providers not being ready for the program. A third postponement would be devastating to the entities that have prepared for all three implementation dates.

Seamless integration will happen for many covered entities because they did the planning necessary to implement. Planning that included several phases, such as:

• Creation of a program for ICD-10 implementation
• Gap analysis from ICD-9 systems to ICD-10
• Analysis and planning
• Tools and application development
• Regulatory compliance and testing
• Education
• Production system rollouts

The covered entities that followed the advice of Health and Human Services regarding implementation preparation will have a seamless integration of ICD-10 because they have done the work nearly three times. Most companies are doing dual coding and have started to mirror systems for processing today. These are the covered entities that will benefit from all the hype about planning.

There will be challenges, likely between payers and providers as ICD-10 is different and contains more descriptive terminology. Payers are building systems to utilize the benefits of ICD-10 as a communication mechanism to understand the medical claim. More information will lead to better reporting with a goal of providing quality care that is measured and valued.

It’s difficult to draw the line between a code set and quality of care if you are operating a small practice or are a consumer. ICD-9 analytics provided much needed insight into why people are being treated, funding and benefit expansion, but the terminology is old and archaic.

ICD-10 and the continued updating in a timely manner will prove to be seamless in the future.