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Since 1866, the US has been the only industrialized country in the world to not use the metric system.

Fast forward to the present, and it is becoming the only industrialized country loathe to use the updated ICD-10 system. Why? According to recent AMA reports of possible postponement, physicians do not understand the intended benefits and future value to them or to their patients.

The perceived benefits of ICD-10 are in fact difficult for physicians and patients to glean in the short term. The sidebar of benefits below emphasizes that the value comes further down the road, in a long-term manner. When the 'whys and why nots' of ICD-10 implementation are analyzed, it's important to consider the bigger picture. ICD-10 goes beyond physician usage and looks to trending and reporting for the CDC.

Benefits of ICD-10 *

• Measuring the quality, safety and efficacy of care
• Designing payment systems and processing claims for reimbursement
• Conducting research, epidemiological studies, and clinical trials
• Setting health policy
• Operational and strategic planning and designing healthcare delivery systems
• Monitoring resource utilization
• Improving clinical, financial, and administrative performance
• Preventing and detecting healthcare fraud and abuse
• Tracking public concerns and assessing risks of adverse public health events
• * As reported by the Centers for Medicare and Medicaid Services (CMS)

Providing the top reason for hospitalization to a state newspaper was done first by grouping discharges by MDC, which were not specific enough; the next step was DRG codes, which were also not telling of diagnoses. Finally, the data had to be grouped by ICD-9 diagnosis codes. It was surprising to see how many "unspecified" codes were being reported. It became weren't providing the data and statistics necessary to paint the entire patient picture were not being provided.

The pushback from physicians is understandable because ICD-10 undoubtedly creates more time and more documentation. However, ICD-10 will finally allow for an overall of the National Coverage Determination and Local Coverage Determination. This may result in the refinement and expansion of allowable codes to justify medical necessity. For example, many physicians still use an ICD-9 "cheat sheet," but many of the codes are non-specific and may not even warrant medical necessity. Under ICD-10, more defined codes will allow for more descript reporting of the patient's condition, and should assist in decreasing denials due to lack of medical necessity.

Beyond the documentation argument and rebuttal, there is the issue of cost to physicians. There is no denying the money that must be invested in new systems, people and processes. But then again, investment in time and money is always required to change a severely outdated system or process.

To hold off on the rollout of ICD-10 would be a potential catastrophe and a huge mistake. On the subject of investment, there are currently countless budgets across the nation devoted to ICD-10 implementation programs. To set the date back further would strip the urgency of the matter and in the long run (no pun intended), no one would take the initiative seriously.

Almost every major country except the United States has made the move to ICD-10. It's time to push forward, look ahead and focus on the future of patient care and reporting. After all, the point has already been proven with resisting the metric system, so perhaps let's enable the US to join other industrialized nations and adopt ICD-10 on time and in good fashion. Agreed?

Source: Billian’s HealthDATA