Day 2 for ICD-10 -- and the World Hasn't Ended

Posted on: in [ CMS, VGMU ]

By Dorothy de Souza Guedes, VGM Education

Health care providers and people involved in medical billing and coding are well aware that ICD-10 went into effect on October 1. But  those who aren't coders or billers may not understand what ICD-10 is -- or why people working in health care are stressed out this week.

People with a lot of time on their hands have found the humor in ICD-10 by discovering funny ICD-10 codes. HealthcareDive's Katie Bo Williams found a code for "sucked into a jet, subsequent encounter," for example. Keith L. Martin of MedicalEcomonics.com listed "bitten by a cow" and "pecked by a chicken," among other funny codes under ICD-10. Healthcare IT News has provided this infographic:
 

 infographic

But you may need to know the serious side of ICD-10. So what's ICD-10? The tenth revision of International Classification of Disease (ICD). It's an international standardized system for documenting diagnosis and procedure codes.

"The new code sets have updated medical terminology, classification of diseases and procedures. These changes will allow for better data comparisons in tracking health conditions, improve clinical decision making, help to more quickly identify fraud and abuse, improve disease research, and help to better design payment systems and claims processing," Lisa Eick, RN,  wrote in a VGM Education white paper, ICD-10: Ready, Set, Code!"

VGM Group, Inc., has a website dedicated to ICD-10 issues related to HME, ICD-10 Resource Center.

"ICD-10 features expanded alphanumeric code sets, as well as an expanded number of codes—68,000 vs. 13,000 under ICD-9—to identify disease etiology, anatomic site and severity," according to HME News.

ICD-9 is so last week

The previous code system, ICD-9, has been used in the United States since the 1979. Those in favor of the switch to ICD-10 argue that the previous version hasn't kept up with the medical field because it only provides limited data about a patient's medical condition.

Since 2008, the federal government has set ICD-10 deadlines of 2011, 2013, 2014.  As every deadline loomed, the date got pushed back -- until now. Randy Lilleston's easy-to-read article on HealthcareDive.com explains the basics of what's happening this week, in "Hell freezes over: ICD-10 becomes a reality."

Many American health care providers have fought the implementation of the newer version of health care codes for more than 20 years. That's when the World Health Organization (WHO) adopted ICD-10 and since 1994 countries have been transitioning.  The  UK jumped on board in 1995; Sweden, Denmark, Finland, Iceland, Norway between 1994 and 1997; Australia in 1998. China beat the United States by implementing ICD-10 in 2002.

So what's the big deal?

So why is it a big deal to health care providers? There are technology issues, staff training issues -- and dealing with people who just don't like change. Imagine changing any system to include five times the detail -- and not getting paid if you don't. "According to a recent HME NewsPoll, 70% of respondents say they expect some disruption in cash flow as physicians and payers navigate the new code set," HME News.

Centers for Medicare and Medicaid Services (CMS) has an ICD-10 Coordination Center(ICC) and ICD-10 Ombudsman. The ICC provides answers to questions about ICD-10 and Medicare Claims. This is likely a pretty busy week for William "Bill" Rogers, MD, the ICD-10 ombudsman. He's an emergency room physician and he blogs.

Rogers should have enough time to get used to his role before WHO releases ICD-11 in 2018.