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Moving Forward on ICD-10

November 5, 2010
by Mark Hagland
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Interview: Tony Trenkle, Director of the Office of E-Health Standards and Services, CMS

As the deadline approaches for healthcare organizations to make the transition to the ICD-10 coding system from the current ICD-9 system for federal reimbursement, many providers remain challenged by a thicket of practical and logistical issues. Recently, Tony Trenkle, director of the Office of E-Health Standards and Services (OESS) at the federal Centers for Medicare and Medicaid Services (CMS), spoke with HCI Editor-in-Chief Mark Hagland regarding the challenges providers are facing, and his office’s work in support of their transition. He also discussed the coming transition to the Version 5010 standard for some electronic health transactions. For more information readers can review the Jan. 15, 2009 news release on the CMS Web site.

And they can read more about the ICD-10 transition on CMS’ outreach Web site on the subject

Healthcare Informatics: The looming deadline of October 2013 remains rather daunting to providers. What’s your sense of how quickly and effectively patient care organizations are moving forward to prepare for the ICD-10 transition?

Tony Trenkle: I do acknowledge that there are a lot of different mandates out there, and there are a lot of key initiatives that have begun since the initial ICD-10 regulation came into place a few years ago. A number of organizations are moving forward rather quickly to implement ICD-10; others are lagging behind. We work rather closely with provider associations and health plan associations, not only to measure where everybody’s at, but also to look at ways we can assist different provider groups or other entities to move forward.

HCI: There has been some buzz in the industry about the deadline. Is there any chance the deadline could be moved in any way?

Trenkle: Well, I’m not planning to move it at all, so unless legislation were passed, or through a statute change, that won’t happen. The deadline remains Oct. 1, 2013; and the Affordable Care Act [the federal healthcare reform legislation passed in March 2010, the Patient Protection and Affordable Care Act] also includes several references to ICD-10, because they recognize that the ICD codes are very much integrated into the business processes in healthcare today, so if you add additional granularity, it will, for example, allow providers to code more accurately, which should assist in getting claims paid more quickly and create less of a problem in terms of understanding what the diagnosis is. And there are certainly elements of granularity in ICD-10 that will assist in terms of quality evaluation as well. So while there may be talk of date changes, the code set change is long overdue, and it’s critical to make that change to help support the Accountable Care Act. In addition, I would add that the transition very much enjoys bipartisan support; the final publication of the regulation took place on Jan. 16, 2009, about a week before the inauguration of President Obama.

HCI: What are people most struggling with, from what you’re hearing?

Trenkle: One, as I said, is the fact that this is one of several important initiatives right now; a second is the need for training and preparation; and the third is that there’s a lack of understanding of when the transition actually is. So we’ve been involved in outreach efforts. One of those efforts involves, our outreach site. If you go out to it, one of the things you’ll see is that we do several things with this Web site, we’ve divided it up into several sections, including provider resources, payer resources, and vendor resources. And we’ve tried to link that site with those of the various stakeholder associations, so we can have a two-way communication with them; we also now have a listserv that you can register for right on the Web site, and we’ve got over 11,000 subscribers to that. The listserv sends out weekly updates for any information on the Web site or messaging. We haven’t yet set up any types of discussions on there, though that might be a possibility. But we’ve also engaged all 10 regions of CMS with an ICD-10 lead, who gets out to the local medical societies and other key stakeholders in their regions. For example, each region of CMS has a chief medical officer, who goes out and meets with physicians. We’re also meeting with various stakeholder groups.