Health care industry continues to butt heads over ICD-10 deadline

Health care industry continues to butt heads over ICD-10 deadline

As the ICD-10 implementation date moves closer, health professionals across the industry are entering into a heated debate regarding whether or not the date needs another postponement. In the past, the federal government has pushed the date back to give providers and hospitals more time to prepare for the new coding set. Many experts believe that another postponement is necessary to properly train staff, perform end-to-end testing to prepare their electronic health records and manage their payment processes and diagnostics in hospitals. 

Industry debates ICD-10 deadline
Many providers who are prepared for the transition are wondering whether another delay will really benefit the health care sector, as the last couple of postponements have left the majority of health professionals unprepared. 

The American Medical Association recently asked the Centers for Medicare and Medicaid Services for more time, explaining that past delays were not enough to allow it to accurately prepare for the major transition. AMA officials noted that many of the federal requirements, such as meaningful use regulations, have made it more challenging to prepare for the transition to the new codes. 

"While the AMA appreciates that physicians have additional time to comply with ICD-10, we continue to have fundamental concerns about ICD-10 and its implementation, which will not be resolved by the extra time," AMA President-elect Steven Stack said in a public statement. "The AMA has long considered ICD-10 to be a massive unfunded mandate that comes at a time when physicians are trying to meet several other federal technology requirements and risk penalties if they fail to do so."

Multiple bills that either fight for resources to help providers ensure a smooth transition or to put an end to the ICD-10 codes altogether have triggered doubt that the codes will end up being implemented on Oct. 1, 2015. However, despite these bills and the pleas of the AMA and other leading organizations within the health care sector, the implementation date seems to remain in place. 

Detailed codes require significant prep
The CMS has worked to make sure that the ICD-10 codes will not negatively impact the industry. It has conducted end-to-end and acknowledgment testing with general health physicians. Even though acknowledgement testing only shows how many providers have submitted a claim, end-to-end testing moves the claims from the submission to receipt of remittance advice. These efforts to ensure an easy transition are essential, as a successful switch from the ICD-9 to ICD-10 codes will improve the quality of patient care. 

The new codes have a greater amount of detail compared to the ICD-9 versions, covering more injuries, diseases and prevalent medical conditions that are not currently included in the ICD-9 set. The Journal of the American Health Information Management Association recently highlighted a few of the most detailed codes featured in the ICD-10 set. For example, the H93.11 is a new code that covers tinnitus, which is a constant ringing or piercing sound in the right ear. According to the journal, an estimated 10 percent of patients in the U.S. experience the condition at least once a year. 

Similarly, there are also seasonal codes, such as the L55.9 Sunburn code. This is used when a patient has spent too much time in the sun and has experienced a painful burn that requires medical attention. Specific codes like these will surely benefit the industry, but do demand a lot of prep work and training from health professionals in order to prevent serious setbacks following Oct. 1. Although the battle continues for another delay, providers must ensure that they are training their staff and preparing their EHR systems so they can provide high-quality patient care when the deadline does come, regardless of whether it is on Oct. 1.