The Rocky Road to ICD-10 Medical Code Implementation

The US healthcare industry has been grappling for too many years now with the implementation of ICD-10 medical codes. The new ICD-10 code set promises to improve the classification of the massive and growing reservoir of health information and to bring the United States up to the international standard for healthcare documentation.

There is no question that the US is lagging significantly in this vital health information area. Most other developed countries have long since adopted and implemented the new standards. The need for an upgrade to the current system was identified formally in the early 1990’s when the National Committee on Vital and Health Statisics affirmed that the current code structure was “broken”. The numerous delays in implementation since that time can be traced to a handful of short-sighted economic and political considerations. Regardless of the cause, the US healthcare system can ill afford additional delays. The quality and integrity of health data in the US has been declining for several decades now.

The deterioration of health data can be blamed in large measure on the fact that the US has simply outgrown the ICD-9 medical coding system. While ICD-9 served the industry adequately for a number of years, the growth in medical procedures, treatments, diagnoses and technology have surpassed its limited adaptive capability. The universe of available ICD-9 codes is rapidly dwindling and certain code sets are becoming oversubscribed. This is resulting in tremendous inefficiency and is calling into question the integrity and completeness of the data delivered through the system. As the risk of compromised patient care increases, the need for change is becoming more obvious.

Advantages of the ICD-10 Medical Code Classification System

Implementation of the ICD-10 medical code set will confer a number of significant advantages on the industry. These include:

  1. Greater specificity and accuracy in healthcare documentation
  2. Reduction in manual intervention arising from the limited descriptive capability of the existing code set
  3. Increased level of detail in the final health record
  4. Improvement in care decisions with elevated data quality
  5. Reduction in errors and quality assurance activities
  6. Reduction in reimbursement holdups due to inadequate information or clarity
  7. Increased productivity of coding practitioners as automation becomes more applicable throughout the entire process
  8. Increased compatibility with other global health information systems
  9. Improved patient outcomes

Conclusion

While there are certainly some compelling economic costs associated with full adoption and implementation of the ICD-10 code set, the costs of non-adoption are growing every day and threaten to dwarf real implementation costs. Additionally, the negative impact on patient care will increase exponentially as the existing data model becomes less stable. The evidence for successful implementation is readily available. Virtually every other major developed country in the world has successfully adopted ICD-10. The time for discussion and analysis is past. The time for bold action and implementation is here.