ICD-10: How will the change affect your life?

Last week I attended a webinar hosted by Healthcare Informatics about the transition to ICD-10. The webinar was sponsored by Cognizant Technology Solutions and was presented by Janice W. Young from Health Industry Insights and David Hamilton of the Healthcare & Life Science Practice at Cognizant. I am fond of the webinars hosted by Healthcare Informatics. They allow me to gain lots of information about the business of health care in a brief period of time. If you have never attended one, you might find it enjoyable and informative…or extremely anxiety producing, depending upon the topic.

I do not know what the total attendance at this ICD-10 webinar was, but judging by some of the questions asked, the range of participants was huge. The program was aimed at providers, payers (insurance companies), clearinghouses, application vendors, and anyone else who might be affected by the transition from ICD-9 to ICD-10.

Those of you who have no idea what I am talking about might want to start to get some information about this transition. Federal law and HHS rules require that we move from the ICD-9 and CPT-IV to the ICD-10; the deadline for doing so has been moved to October 1, 2013. It will be very interesting to see if we actually get there in time.

We who work in behavioral health have fairly minimal changes to make. The number of diagnostic codes and procedure codes utilized in mental health claim filing (and upcoming behavioral health EMRs) is minuscule compared to the larger health care arena. Software like ours will require minimal modification; but in the general and specialty medical world, the changes will be massive.

Not only are different diagnostic codes required, but the ICD-10 is also a procedural nosology that most of the rest of the world has been using for many years. It allows a much more finely-grained statement of both diagnoses and procedures utilized. Many believe that data obtained from use of the more specific codes is part of what will allow health care cost savings in the future.

The biggest challenges will involve learning the new code sets and translating our current data into something akin to the new codes. I say ‘something akin to’ because there is not a one-to-one mapping from the ICD-9 and CPT-IV to the ICD-10. In fact, the logic of the two systems is quite different. Reports are that CMS is working on a general equivalence map (GEM) between the two systems. Work will continue on testing and tweaking the GEMs for at least three years after the 2013 deadline.

Private market mapping and consulting also exists. Last week, 3M Health Information Systems announced the release of their own mapping tool in a Healthcare Informatics article. While insurers and clearinghouses and hospital systems may make use of these proprietary tools and consulting services, it is likely that the CMS GEMs will work for many of the rest of us.  

I can feel the chill going up and down the spines of professional coders. In just a few years, they will need to be fluent in another language. My niece just finished a program to be a coder and is now studying for her certification. She will be able to just keep right on studying to be ready by 2013. This is not encouraging for someone who has been coding for 30 years, but for a youngster, being newly fluent in ICD-10 will be a very salable skill.

What preparations do you foresee your organization making to get ready for ICD-10? Have you begun to consider this process? Tell us what you think. Just enter your comment by clicking on the title of this article and typing your thoughts in the box below.

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