Updates to Medical Codes Delayed: Why Should You Care?

Share By Sachin Shenolikar

Every ailment that your doctor treats has a code. That includes the common cold, various types of cancer, broken bones, as well as burns suffered as a result of water skis catching fire.

Yes, there’s a code for each of these maladies — and many more. It’s called the International Statistical Classification of Diseases and Related Health Problems (ICD).

The current system, ICD-9, is nearly four decades old, and the new ICD-10 is on the way. However, in April, the House of Representatives passed a bill that delayed the transition from ICD-9 to ICD-10. Originally expected to go into effect this October, the deadline for all providers to be ICD-10 compliant has now been pushed to October 2015.

To some observers, the delay in the switch to ICD-10 is not a big deal. However, the American Health Information Management Association (AHIMA) estimates that the delay could have wide-ranging consequences that cost the health industry up to 6.6 billion dollars.

Keeping that eye-popping number in mind, let’s explore how this issue will affect patients.

First, there’s the state of the current ICD-9 system. Simply put, it is old. In order to provide the cutting-edge healthcare that consumers demand, the tools need to be updated. “We’re using a system that was created 35 years ago,” says Erik Newlin, Director of National Standards Consulting at Xerox.

“Look at anything — would you use a cellphone that was created 35 years ago? Technology has moved on, and the same is true of ICD-9.”

One area that both doctors and patients will be affected is billing. “Doctors complain every day about not being paid appropriately for the right kinds of services. Consumers complain about being overcharged for things,” says Newlin. “At the end of the day, the data behind it is bad. Every single thing used to manage healthcare in the back end is touched by diagnosis coding — and if you’re still using old tools, will you ever get the benefit?”

There will also be an impact on the progress of big data in healthcare. Researchers have been trying to figure out how to analyze digital information to discern if a patient is receiving proper care, predict whether a patient is at greater risk for a specific disease, and even proxy interactions with physicians that otherwise would not have been possible. ICD-9 is not sophisticated enough to handle rich data that is needed to take the next steps in big data analysis.

“The basic impacts go down to a very fundamental level of disease management,” says Newlin. “You have medical professionals that are inclined to gain appropriate intelligence about various disease states, and there’s no way to do that in any efficient manner using a system that’s 35 years old.”

When the time arrives, expect the large-scale ICD-10 implementation to have some hiccups at first. Newlin expects a learning curve of about six months. But within two years, enriched information will be in place and we will start seeing results. “If the right amount of planning has been put in place, the impact can become more administrative in nature, without disrupting care,” says Newlin.

The bottom line: With so much at stake for the future, it is crucial that the change to ICD-10 happens sooner rather than later.

“People’s health is absolutely critical. We have to find better ways to spend the dollars that are in play,” says Newlin. “It’s time to put the right tools in place to make better decisions.”

For more information on ICD-10, visit the Xerox government healthcare site here.
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comments (1)

  1. jitendra medical coding

    yes i agree to implement icd10 as sooner as possible, anyway we have to use new codes one day and leave icd 9 codes

    Reply

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