ICD-10 Procrastination—How Long Can we Delay the Inevitable?

It’s fascinating to see the array of opinions on the thorny issue of ICD-10, which the industry is racing forward to a comply with the Oct. 1, 2013 deadline. The most recent waves that were made on this topic was on Nov. 15 when the American Medical Association (AMA), the nation's largest physician association, took a vocal stand against ICD-10 implementation during its semi-annual policy making session. And then a day later the American Health Information Management Association (AHIMA) stepped up to voice its disappointment in response to AMA’s opposition and encourage the industry to move forward with implementation.

But the question remains—how long can we delay the inevitable? Endorsed by the World Health Organization (WHO) back in 1993, ICD-10 is currently used in countries like Australia, Canada, France, Sweden, Korea, and the U.S. is the only industrialized nation currently not using the coding system. The original proposed ruling from HHS set compliance deadlines for 5010 standards and the ICD-10-CM code for just last month (Oct. 1, 2011). After public comment urging HHS to extend the deadline in December 2009, the 5010 standards was pushed back by one year and ICD-10-CM codes moved back by two years. And according to AHIMA’s Sue Bowman, director, Coding Policy and Compliance, ICD-10 compliance is 10 years too late.

This issue reminds me of a friend who has been putting off of the inevitability of planning for her wedding, saying that she’ll start after the holidays, which will only be a few short months before her big day. Every time we talk about it I cringe. I’ve been planning for my 2012 wedding since 2010, partly because I’m planning an out-of-state wedding, and partly because it’s in my nature to plan ahead. I wonder if the industry just stopped procrastinating this ICD-10 transition and put its collective head down, could it pull it off?

Some motivation can be gained if we look at the National Committee on Vital and Health Statistics recommendations, which urged the industry to move forward on ICD-10 implementation despite concerns of stakeholder readiness. At a well attended hearing on June 17, 2011, testimony was heard from a broad spectrum of stakeholders representing health plans, providers, clearinghouses, vendors, other government entities, State Medicaid agencies, and others. In a letter to HHS Secretary Kathleen Sebelius, the Committee said:

“There is consensus that compliance is going to be challenging, particularly for ICD-10, but that the deadlines should be maintained and met. Most concerns focused on providers (small providers in particular), and State Medicaid agencies.”

In its recommendations, the NCVHS advocated for more training outreach for the industry, as well as encouragement to industry stakeholders, association contacts, and others to foster testing the updated versions and code sets prior to implementation between trading partners to prepare for the deadline. NCVHS said that many organizations reported they are ready for testing, but can’t find partners with whom to test.

NCVHS also said that HHS should collaborate with organizations like AHIMA to assess current levels of coders in the industry, the number of coders needed by 2013, and the potential gap, and should invest in expanding educational opportunities and resources to increase workforce capacity and training resources.

So, back to my friend, if she just started planning, set some goals, and asked for some help, I really think she could pull off a fabulous wedding. Either way, the day is going to happen; it’s just that with early preparation, she might be able to stave off the heartburn associated with procrastination.