As most of you are probably well aware, the Department of Health and Human Services (HHS) has announced a proposed delay in the implementation of the ICD-10 diagnosis coding system for one year, until October 2014.
No doubt, many were quite surprised by the original announcement in February of the intent to delay, despite comments last fall from the American Medical Association (AMA) and other entities that they were campaigning for such action. Preparation had been underway at least to some extent by most health care providers, and many have already spent large amounts of money and time in planning and training for the implementation.
Reaction to the proposed delay is decidedly mixed. The AMA and many physician specialty societies and practices across the country have praised the actions of HHS. They have expressed serious concerns about the lack of readiness by health care providers, as well as the financial and operational burdens that ICD-10 entails – especially coming on the heels of health care reform, the electronic health record (EHR), and government programs such as “meaningful use.” On the other side of the debate are many of the organizations devoted to health information management and technology. They have issued several communications on the issue since the intent to delay ICD-10 was announced earlier this year, pointing out the importance of moving forward with what they describe as a much-needed improvement to current diagnosis coding and also their concerns that a delay itself will be costly to health care providers.
Finally, in the midst of all this uproar, there were even a few whispers that HHS should scrap ICD-10 altogether and plan to move directly to ICD-11 instead. (Be honest now, did you really even know there was an ICD-11 out there?) ICD-11 has been under development by the World Health Organization (WHO) for several years. Early indications are that it will be poised to take full advantage of the latest technology and will better meet the specific needs of primary care and specialties, in addition to focusing on current health care initiatives such as quality measurements. However, the WHO timeline for ICD-11 does not call for the final version to be ready until 2015 at the earliest and, meanwhile, industry experts tell us that ICD-9 is obsolete, does not reflect the needs of the 21st century and cannot maintain its viability that long (e.g., it is literally “running out of numbers”). Based on the recent announcement, however, it appears that ICD-10 will be implemented in 2014.
So what is a provider to do? Right now our best advice is to move forward cautiously, keeping watch for HHS to announce that the proposed delay has been finalized and forging ahead with required items (such as version 5010 for electronic administrative transactions, which has had its own compliance date delayed until June 30, 2012). Planning for ICD-10 should also continue, perhaps with a flexible timeline for training programs and other necessary preparations. As is often the case in health care, we will all need to “stay tuned” for further developments.