The American Medical Association (AMA) House of Delegates voted to “work vigorously to stop implementation of ICD-10” during the closing session of its semi-annual policy-making meeting November 15.
The AMA cites the number of competing healthcare initiatives and the costs involved in the transition as reasons it opposed the switch. It’s a little late in the game to be figuring that out.
Providers should not put their implementation plans on hold. Many (hopefully most) providers and payers are already planning for the ICD-10-CM/PCS transition. Some have even started updating systems, forms, and processes. CMS representatives have repeatedly said the deadline isn’t changing. And really, too many good reasons exist for the switch.
Consider these factors:
The United States is the last industrial country to implement ICD-10-CM/PCS. We’re 10 years behind Canada and even farther behind Europe. Beyond how embarrassing it is to be so far behind the rest of the developed world, we can’t share data with other countries because we’re using a different code system. We can’t compare disease or mortality rates because it’s an apples to apricots comparison. And by the time we implement ICD-10-CM/PCS, most of the rest of the world will be looking at ICD-11.
ICD-9-CM is out of room. Every year, Centers for Disease Control and Prevention add more and more out of sequence codes, which creates confusion for coders because the code isn’t where it should logically be. ICD-10-CM contains thousands more codes already and has plenty of room to expand in the future.
Increased specificity is a good thing. Many ICD-9-CM codes lack detail, especially ICD-9-CM Volume 3 procedure codes. How can you justify your patient is really, really sick if you can’t explain why? In ICD-9-CM Volume 3, you can’t even distinguish between a central venous catheter insertion and a peripherally inserted central catheter. They both map to the same code (38.93). In ICD-10-PCS, coders can report percutaneous placement of venous central line in right internal jugular (05HM33Z) for example. Of course, the physician has to document enough information for the coder to select the correct code.
Documentation is going to continue to be a big problem. We all know that.. ICD-10-CM/PCS requires more information and in some cases different information than ICD-9-CM. But generally it’s information the physician already knows and he or she just isn’t writing it down. For example, if a physician sets a broken arm or removes a foreign object, he or she should be able to say which arm the patient broke or where the foreign body was.
The documentation will also help with quality of care indicators and outcome assessments. If a very ill patient makes a tremendous recovery because of a provider’s excellent care, the provider will be able to show just how sick the patient was and how well he or she recovered.
Change is never easy. The transition to ICD-10-CM/PCS won’t happen overnight and it won’t be easy. But it will benefit the healthcare profession all around from coders to HIM to physicians and (ultimately) patients. Instead of digging in its heels at this late date, the AMA should be looking for ways to make the transition better and easier.