Beyond Coding: Will the ICD-10 Deadline Delay Help or Harm?

At HIMSS, I met with many healthcare CIOs as a part of CHIME focus groups to discuss their readiness for ICD-10. One area we explored was the impact of the delay. Most were a bit frustrated by the delay because they had committed the resources and money to an ICD-10 transition plan which was well underway. In some instances CIOs estimated they had expended at least 50 percent of the effort required to meet the compliance deadline. In fact, in one of the focus groups, 10 out of 12 participating CIOs said the delay will be more harmful than helpful. I heard two main reasons for this position:

1. Cost: Hospitals have already committed the resources and budget to transition to ICD-10, and now they will have to continue that effort for a longer period of time.

2. Engagement: It’s harder to engage staff around the importance of clinical documentation and coder education when the media is saying “delay, delay, delay” – it makes it difficult for leaders to convince providers and other stakeholders that it’s a critical priority.

A survey conducted by Edifecs validates this sentiment – 90 percent of healthcare professionals believe that the deadline should not be moved more than a year. Fifty-six percent said that a two-year delay would be “potentially catastrophic.”

However, for smaller physician practices, the delay likely has the opposite impact – more help than harm. Many of these practices were struggling to understand the impact of ICD-10 and find the resources to prepare for the October 2013 deadline. A delay gives them more time to put a plan in place, improve clinical documentation, and ensure they can get reimbursed for services.

The bottom line is, helpful or harmful, the ICD-10 transition has been delayed. What can healthcare organizations – both large and small – do now to make the best use of the additional time? Now is the time to focus on improving clinical documentation, coder education, and align those efforts with EMR adoption and other initiatives with the goal of improving quality of care. The healthcare organizations who take advantage of this time and focus on improved clinical documentation will be better prepared and more likely to benefit these changes. Our recently published book, titled “Beyond Coding: How ICD-10 Will Transform Clinical Documentation,” provides a research-based methodology and foundation for what healthcare professionals can work on today.

One final note – some are already calling for a jump straight to ICD-11 given the deadline delay. It’s an interesting argument, and when the new deadline is announced, there will certainly need to be decisions made about ICD-10 versus ICD-11. I believe that ICD-11 is ultimately where the industry needs to be – it brings even more value than ICD-10. However, ICD-10 is an important stepping stone, as the differences between ICD-9 and ICD-11 are monumental and would be difficult for an organization to manage all at once. Let’s prepare for ICD-10 today so we can benefit from ICD-11 in the future.

Heather Haugen, PhD, corporate vice president, research, The Breakaway Group, a Xerox Company.

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2 replies »

  1. You have to take the organizations that are unprepared into account – and there are certainly many of those. For them, the delay could be very beneficial in terms of preventing productivity loss and errors.

  2. I believe correct coding and the ICD in general is something hospitals have trouble with. They lose a lot of revenue due to undercoding. I think a lot of patients suffer when non-profit hospitals can’t generate enough revenue to sustain themselves. There seem to be a lot of solutions in the market that can help the coding staff. But I think what is required is a more holistic approach to this problem. I came across a solution online which does exactly that – http://payerprovider.com/solutions/reducing-the-impact-of-workload-on-hospital-revenue/
    The cost of transitioning to ICD-10 can be compensated if the hospitals focus on identifying revenue leaks and can efficiently cap these leakages. I think it is important for healthcare organizations to keep these in check and seek innovative solutions to increase revenue!