ICD-10: Why This Release is Actually Old News

ICD-10:  Why This Release is Actually Old News

The ICD-10 (International Classification of Diseases, Tenth Revision) is mandated for release and implementation in the United States beginning on October 1, 2015, and many insurance providers, physicians and other medical professionals are concerned over possible delays in reimbursements. Since ICD-9 has been is use for almost forty years, tens of thousands of new additions to the medical coding system have been added.

CMS.gov (Centers for Medicare and Medicaid Services) assures us that the deadline allows ample time for the healthcare industry to adapt to this change, but it will still be a huge adjustment. As the deadline nears, more information is surfacing about past delays in implementing this much-needed, long overdue update. While the US Department of HHS (Health and Human Services) finalized the date of implementation in our country for 2015, ICD-10 was already endorsed by the World Health Assembly way back in May 1990 and came into use by WHO (World Health Organization) members in 1994 and is currently functional in 194 WHO member states.

Over the next few years, while the United States continues to understand and uncover the myriad of changes coming with ICD-10, the rest of the world will be embracing an even newer version, ICD-11, which is set for release in 2017. This pushes the US decades behind our neighboring global countries in recognizing new diagnoses and medical coding.

At this point, should we delay implementation of ICD-10 even further and wait for ICD-11 in 2017, or does that put us at risk of falling even further behind? The Centers for Medicare and Medicaid Services (CMS), which plays a major part in implementing the ICD system in the U.S., says in a fact sheet that “it is not feasible to skip directly to ICD-11 because ICD-10 is a foundational building block prior to moving to ICD-11. Several prominent industry groups, including the American Medical Association, have issued statements opposing transitioning directly to ICD-11 because of the complexity of the coding system and the best practice to implement ICD-10 to gain experience with that system first.”

We continue to stress the importance of the proper preparation for ICD-10 implementation. We are extremely confident that CMS will move forward with the upgraded medical coding system on October 1, 2015. Practices should be prepared for potential delays in payments. Now is the time to properly train your staff in ICD-10 implementation. Attend seminars, meetings and become familiar with all software upgrades from your practice management software provider. We recommend that your organization should have access to funds that will cover a minimum of six months of cash flow to support your business operations. If you do not have a reserve of six months of cash to cover your operational expenses, now is the time to approach your bank for a line of credit. Do not wait until the last minute to obtain access to a line of credit to mitigate any decreases in cash flow.