ICD-10: The Good, the Bad, and the Ugly

Background

For the past 30 years, US medical professionals have been using the ninth revision of the International Classification of Diseases’ diagnosis codes (ICD-9). However, beginning October 1, 2014, all US HIPAA-covered practitioners will switch to the tenth revision (ICD-10). Why, you might ask? Well, according to the Centers for Medicare & Medicaid Services (CMS), in addition to being outdated and inconsistent with current medical practices, ICD-9 codes produce limited data about patients’ medical conditions and, because of its structure, ICD-9 cannot expand to include new diagnosis codes as they become necessary in modern healthcare. In other words, ICD-9 no longer serves our needs—and hasn’t for quite some time.

The Good

ICD-10 will allow providers to be even more specific and exact in describing patient diagnoses, thus improving interoperability, data sharing and outcomes, evidence-based practice, and ultimately public health. And we’re not the first to make this transition. In fact, we’re the last country in the world with modern health care to do so. In 1998, Australia adopted ICD-10, and in 2001, Canada did as well. Although it might appear that we’re a little late to the party, it could be for the best. After all, there is a lot that we can learn from our friends Down Under and our neighbors to the north, including the benefits of planning and training early. We have just over one year to get ready for the transition, and that’s plenty of time—if we start today. The first step is to acknowledge and understand the good.

The Bad

As with any change of this magnitude (ICD-9 consists of about 13,000 codes and ICD-10 will consist of about 68,000), there will be obstacles, such as a learning curve that likely will result in a productivity dip and payer processing hiccups that may delay claim reimbursements. In fact, experts recommend having at least six months’ worth of cash revenue available to ensure your practice can stay afloat through 2015. That can be more than a bit frightening, but there’s hope. Like I mentioned above, we have a year to prepare ourselves, our staffs, and our clinics so together we can weather the storm and come out even better on the other side.

The Ugly

There’s a scale on which you can choose to view the impending ICD-10 transition, with one side focusing on the negative, the other side focusing on the positive, and a million different perspectives in the middle. The key word above is choose, as in you get a choice in how you’re going to handle the change. What you don’t get to choose, however, is whether or not the switch takes place. So instead of pouring time, energy, and resources into an ugly outcry about how terrible this will be, let’s let that part go, and instead, pour the same time, energy, and resources into getting ready. After all, it won’t be all bad. There are tons of opportunities here for ICD-10 to really improve the state of our nation’s healthcare system—and we know it can use all the help it can get. So let’s focus on that—the good.  Let’s tackle this with our heads held high, use the resources available (there are plenty), start training now, and choose to view it as an opportunity for greatness.

What’s helped you prepare for the ICD-10 transition? What do you see as the benefits of making the switch? Tell me your thoughts in the comments section.

About the Author

Heidi Jannenga was a scholarship athlete at the University of California, Davis. Following a knee injury and subsequent successful rehabilitation, Heidi developed a passion for physical therapy. She started her 16-year physical therapy career after graduating with her Masters from the Institute of Physical Therapy in St. Augustine, Florida. In 2008, Heidi and her husband Brad launched WebPT, the leading web-based Electronic Medical Record (EMR) and comprehensive practice management service for physical, occupational, and speech therapists. As the company’s COO, Heidi is responsible for product development/management, billing services, and customer support. Through her role with WebPT, she has had the opportunity to speak as an industry expert at numerous industry trade shows and professional conferences. Additionally, she has participated as a panel speaker at local and regional technology, entrepreneurship, and women in leadership events. Heidi resides in Phoenix with Brad and their daughter.

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