Last week we discussed the arrival of the 5010 transaction standard. The transition to the 5010 standard has many drivers. One of those is the requirement to accommodate the ICD-10 code set that becomes effective October 1, 2013. Thirty-one months may seem like an eternity, but it is not too soon to begin considering the impact the transition to ICD-10 will have on your practice.
How did we arrive at this crossroads?
The ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) code set in widespread use today is based on the ICD-9 code set adopted in the late 1970’s. The International Classification of Diseases is part of the evolution of an effort that began over 150 years ago to systematically classify diseases. Following its creation in 1948, the World Health Organization (WHO) took over the responsibility for the ICD coding system. Under the guidance of the WHO the ICD coding system has been updated roughly every 10-15 years. ICD-10 has been available since 1994 and has been adopted by most of the countries in the world. In the United States, however, the ICD-9 code set has been intimately imbedded within the realm of physician and hospital billing for almost 30 years—a fact that has postponed adoption, until now.
How does ICD-10 differ from ICD-9?
Fundamentally, ICD-10 is substantially more granular than ICD-9. This is reflected clearly by a couple of numeric comparisons:
• An ICD-9 code consists of 5 numeric digits; an ICD-10 code consists of 7 alpha-numeric characters.
• The ICD-9 code set contains approximately 16,000 codes; the ICD-10 code set contains approximately 154,000 codes.
Unlike last week’s discussion of the 5010 standard which occurs behind the scenes and out of the physician’s workflow, ICD-10 will be right in the middle of your world, touching everything from diagnoses on your problem lists to the codes you submit to payors for billing and third parties for orders (laboratory, radiology, etc). Outside of the office you will bump into the ICD-10 codes in all venues of care: hospital, dialysis facility and access center.
What can you do to get ready for ICD 10?
First, educate yourself and your staff. As 2011 unfolds, and certainly during 2012, a wide variety of educational programs will surface within your community. Take advantage of these programs. Hospitals and health systems in particular will have a vested interest in educating their medical staffs. Also, pay attention to organized medicine and the resources they offer.
Second, consider the coding and billing programs sponsored by your professional societies. Many nephrologists I know have shunned these programs for years. Late 2011 and 2012 will be an excellent time to turn over a new leaf and see what you have been missing.
Finally, talk to your health IT vendors; over 95% of you transmit claims electronically. Does your billing company or practice management software vendor have a defined strategy to tackle the challenges presented by ICD-10? At least 30% of you are using an electronic health record. Ask your EHR vendor what their strategy is to meet the ICD-10 transition.
The HITECH Act and demonstrating meaningful use have commanded a substantial amount of our attention recently. With only 24 hours in each day it is easy to put some things off until tomorrow. As a word to the wise, pay attention to the 5010 transaction standard and its more popular cousin ICD-10. A couple of trips around the sun and October 1, 2013, will be here before you know it.
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