Bethesda, MD -- A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation looks at an important change expected in the American health system later this year: the transition to the ICD-10 coding system by all health providers for diagnoses and inpatient procedures. ICD stands for the International Classification of Diseases, which is maintained by the World Health Organization. The ICD system, which began in the nineteenth century, is periodically revised to incorporate changes in the practice of medicine. While the most current version, ICD-10, has been used in most countries since its initial adoption in 1990, the United States has until now limited its use to the coding and classification of mortality data from death certificates. This brief examines the debates that have accompanied the broad conversion in this country to ICD-10, set to take place on October 1, 2014.
Topics covered in this brief include:
- What's the background? The brief explains why ICD-9 is outdated and how the coding system is near capacity. It also explains how the new system is different. As one expert describes it, "ICD-10 is able to accommodate new diagnosis and procedure codes for future clinical protocols." The brief also traces the steps taken by the Department of Health and Human Services to transition to ICD-10, including the publication of final regulations in January 2009 and the steps taken by the Centers for Medicare and Medicaid Services (CMS) to ensure that providers will be ready to make the conversion in October 2014.
- What's the debate? The conversion from ICD-9 to ICD-10 is complicated and costly. Proponents maintain that the new code set will have an impact not only on claims submissions, but will provide a more exact and up-to-date accounting of diagnoses and hospital inpatient procedures, ultimately improving public health and quality reporting. Opposition to the implementation of ICD-10 comes from medical associations, who believe that the transition will be overly burdensome on providers already engaged in efforts to comply with new requirements such as meaningful use, e-prescribing, and quality data reporting. With the development of ICD-11 well under way, some maintain that it might make more sense to wait until the next system is ready before making the change.
- What's next? To ease the transition, CMS has an ICD-10 website where providers, payers, vendors, and other affected parties can access official resources for assistance. According to a July 2013 survey, nearly 95 percent of American Hospital Association members said they thought they could meet the October 2014 conversion deadline. Meanwhile, the Obama administration, still smarting from the political fallout from the implementation of the health insurance exchanges, will need to determine if there has been sufficient progress to keep to the deadline.
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