ICD-10: Taking the next step

Okay then – we have an implementation date. It has taken 19 years for the industry to get this close to what is actually a fairly modest goal – upgrade a classification system used extensively in healthcare for reimbursement transactions, quality initiatives, epidemiological tracking and clinical research from the 30-year-old ICD-9-CM to the latest completed version, ICD-10-CM.

Even by government standards, the rate of progress has been a crawl. For some, the crawl has taken them by surprise and so they are not ready. Still others have the idea that rather than crawling toward a well-known goal we should leap straight to a completely different goal.

The path to ICD-10 was anything but straight. Would we humans unanimously abandon all politics, misrepresentation and spin? Would we forego the need for public hearings and stakeholder input? Would we get there with “effective immediately” federal regulations? By what form of wizardry would this amazing feat be accomplished?

You’ve got to walk before you run.

Like all clichés, this one is a cliché for a reason – because we seem to need to be reminded of the simplest things over and over. This industry has been crawling toward ICD-10 for nearly two decades. It needs to stand up and walk before it can hope to run. There are some grand visions for healthcare reform in this country, and many of them aspire to use the power of electronic health records to make the U.S. healthcare system smarter and better, and to help it stay solvent. Superb. Let’s do it. Let’s get an electronic health record in place everywhere, and let’s use the latest completed version of the ICD classification system until the industry has proven it is capable of moving to something more sophisticated.

Nobody has gotten a sweet deal in this compromise. The organizations that have spent considerable time and money preparing for a 2013 implementation date will lose a hefty chunk of that time and money in re-work. The organizations that have not started to prepare have to get going, and the later implementation date does not change the nature of their task. So it would be perfectly accurate in this situation to say that nobody lost and nobody won. Game over, and now there is some work to do. Let’s put politics behind us, change into our sensible shoes and take this next step together, shall we?

Rhonda Butler is a senior clinical research analyst with 3M Health Information Systems. She writes for the 3M Health Information Systems blog and contributes regularly to PhysBizTech via blog series titled "ICD-10 essentials for busy physicians who would rather be doing something else."

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