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Wave Incoming: ICD-10

September 14, 2008
by Mark Hagland
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If the Centers for Medicare and Medicaid Services (CMS) ends up pushing through its proposed deadline for adoption of the ICD-10 diagnosis and procedure codes of October 1, 2011, it could cause a minor earthquake in healthcare. How many patient care organizations would be ready to switch over completely to ICD-10 by then? Close to zero, I’d hazard a guess.

ICD-10 has been talked about for several years now, and of course, several countries with healthcare systems comparable to ours—Germany, Australia, and Canada among them—have already switched over to some version of ICD-10. Experts concur that switching over to ICD-10 in the United States could prove to be a boon for improved data gathering and analysis, and certainly could help boost pay-for-performance initiatives, given the far greater sophistication and nuance in ICD-10 systems compared to our current ICD-9-based system. Some experts have also noted the potential for improving the specificity of clinical decision support at the point of care.

Still, the potential for disruption, confusion, and lost payments is tremendous, at least in the short term. Health information management (medical records) coding professionals nationwide would need to be retrained; and a huge number of applications and databases, both on the provider and payer sides, would need to be modified. On a practical level, things could be a mess for a while.

It will also be expensive. CMS is estimating that it will cost $1.64 billion industry-wide to make the switch, including $356 million in training costs, $572 million in lost productivity costs, and system change costs of $713 million. And the agency figures that it will cost vendors between $55 million and $137 million to adapt their products to the new requirements.

Is there anything concrete that CIOs can do at this point? Right now, reading up on ICD-10 and staying abreast of the news is probably the most they can do on a practical level. But gearing up, at least mentally, for this change with tremendous potential to impact many aspects of hospitals’ operations, is something CIOs need to begin doing now. And it’s yet another aspect demonstrating that CIOs’ success in managing change will be central to their organizations’ success going forward.

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