CMSA Today - Issue 7, 2015 - (Page 10)

ICD-10 ICD-10 Implementation Are We Ready? BY PAT STRICKER, RN, M.Ed T he impending change to ICD-10 has caused an unusual amount of angst for the health care industry. Given the overall changes and highly sophisticated health care procedures available today, should implementing a new set of diagnostic codes generate this kind of turmoil? Sure, they have caused a lot of extra work to prepare for the change, they will cause a slowdown in productivity initially when they are implemented, and they will cause some issues with payments, but do they deserve this much attention? Aren't we always in the middle of some type of major change in health care? We made it through major changes in the past, such as Medicare, Medicaid, ICD-9, managed care, DRGs, and now the Affordable Care Act. They didn't seem to be that catastrophic, so why are we so worried? Most other countries implemented ICD-10 years ago. Once implementation is completed, we will probably look back and say "that wasn't so bad." Remember how difficult it was when computers, and then cell phones, started to invade our quiet, organized lives? Most of us resisted them. Now, can you even think of not having them? They run our lives. Change is inevitable, and we will get through this transition. This article is not meant to be a tutorial on how to get ready for ICD-10. It's too late for that. It is also not meant as training on the specifics of how to use the codes. I assume you have already had training on that (or at least I hope you have). The intent of this article is to provide you with some hints and tips on how to get to the finish line, provide some light-hearted facts and thoughts about ICD-10, and make you feel good about where you are in the process. I'd like us to take a few deep breaths and relax before the "big day." If you are all set for the October 1 date, that's terrific! If you are almost ready - keep going, the finish line is near! If you aren't ready, all I can say is good luck! We need to keep in mind why we are moving to ICD-10. It's not just to keep up with the other countries that have done so years ago. We need to make this change to improve our health care system. * The updated codes will provide current terminology and specificity for the health 10 CMSA TODAY * * * * care being practiced now in the 21st century versus that of the 1970s. The specificity of the diagnosis codes will help us collect more meaningful data about conditions, their interventions and treatments, and their outcomes. We will be able to better manage populations by being able to analyze the data and use it to make quicker decisions. Better data and the ability to measure outcomes will help drive better quality of care. The new codes will help us move toward value-based purchasing and payment reform. HISTORY OF THE INTERNATIONAL CLASSIFICATION OF DISEASES (ICD) Let's start by looking at the history of the ICD codes. Believe it or not, the statistical study of disease began in the 1600s. In 1891, the International Statistical Institute commissioned the development of a classification of causes of death, which became known as the Bertillon Classification of Causes of Death. This document continued to be updated over the years and countries also began to collect data on diseases, morbidity, and injuries. At the 6th International Conference in 1948, the Causes of Death list was combined with lists of diseases, injuries, and morbidity. This became known as the Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death. Today we would describe it as the International Classification of Diseases (ICD-6). The 7th version was released in 1955 and the 8th version in 1965. ICD-9 was introduced in 1975 and implemented in the U.S. in 1979 (36 years ago). Work on ICD-10 began in 1983 and Issue 7 * 2015 * DIGITAL the diagnosis codes were endorsed for use in 1990, with the full release in 1994. Since that time, 138 countries have implemented ICD10 for mortality and 99 countries are using it for morbidity. In 1995, the U.S. made plans to implement ICD-10, but HIPAA regulations enacted in 1996 put a regulatory hold on the process. The ICD10 codes were implemented in the U.S. for mortality coding only (death certificates) in January 1999. The ICD-10 implementation was on-hold until 2003 when Health and Human Services (HHS) was given the responsibility to implement ICD-10 under the HIPAA standards. After more regulatory issues and public comment periods, it wasn't until 2009 that HHS established ICD-10 as the new national coding standard and set an implementation date of October 1, 2013. (That decision only took 13 years, and the implementation was to take another four years!) But the implementation was pushed back to 2014 and then finally to 2015 (19 years after we first started to plan our transition to ICD-10). So you can see why people just want to see it actually happen. And just in time; ICD-11 is just around the corner. Their release is scheduled for 2018, but let's not think about that just yet. We need to get ICD-10 up and running first, and then it should be easy to transition to ICD-11, right? The World Health Organization (WHO) describes the International Classification of Diseases (ICD) as the standard diagnostic tool for epidemiology, health management, and clinical purposes. This includes the analysis of the general health of population groups, the monitoring of incidence and prevalence of diseases and other health problems, and providing a picture of the general health of countries and populations. The codes are used to classify diseases and other health problems; to store and retrieve diagnostic information for clinical, epidemiological, and quality purposes; to make decisions about

Table of Contents for the Digital Edition of CMSA Today - Issue 7, 2015

ICD-10 Implementation
Medicare Fee-for-Service Program
Revisiting “Ready or Not — Here Comes ICD-10!”

CMSA Today - Issue 7, 2015