Healthcare CIO group decries ICD-10 delay by government

Staggering the deadlines for physicians and hospitals will only increase costs

A national organization representing healthcare CIOs and other senior IT leaders is upset about U.S. government plans to delay a deadline requiring a new medical coding system.

The College of Healthcare Information Management Executives (CHIME) its concerned over the federal government's move to delay the deadline for healthcare facilities to roll out the ICD-10 medical coding system .

ICD-10, which is designed to better track diagnoses and treatments, affects dozens of core applications for healthcare providers and insurance payers.

Last week, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius said her agency was starting the process to postpone the compliance date . Sebelius said the move was in response to healthcare providers who expressed concerns over the administrative burdens they face, including the rollout of electronic medical records by 2015 .

HHS's move follows a similar one in November by the U.S. Centers for Medicare & Medicaid, which announced it would delay enforcement a new standard for how medical transactions are processed, known as Version 5010. Version 5010 is needed for the adoption of the new ICD-10 medical coding system standard.

CHIME, which has 1,400 CIO and 70 healthcare IT vendors and professional services firms as members, issued a letter in response to the HHS action, saying delaying the ICD-10 deadline "will create more problems" than it solves.

The compliance date for upgrading to Version 5010 standards for electronic health transactions moved from Jan. 1, 2012 to March 31, 2012. The transition to ICD-10 for medical diagnosis and inpatient procedure coding was slated for Oct. 1, 2013. A new deadline has yet to be set by HHS.

"We strongly urge HHS to move quickly and decisively in setting a new compliance date for converting to ICD-10. Every day that passes without a concrete deadline is another day that should have been spent planning and implementing this critical undertaking," the organization wrote.

The move from ICD-9 to ICD-10, which replaces about 15,000 codes with approximately 68,000 new ones, comes at a time when care providers are already under the gun to implement and prove to the federal government the meaningful use of electronic health records (EHR).

ICD-10 codes provide more robust and specific data that will help improve patient care and enable the exchange of U.S. health care data with other nations already using ICD-10. Entities covered under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) will be required to use the ICD-10 diagnostic and procedure codes.

ICD-10's complex code and its impact on EHRs, various billing systems, reporting packages and other decision-making and analytical systems will require major upgrades or the replacement of current systems.

The changeover will probably cost larger hospitals between $2 million and $5 million, and large care groups as much as $20 million, said James Swanson, director of client services at Virtusa, an IT services and consulting company.

ICD-10 will also require staff at hospitals and private physician practices to map and load codes, redo system interfaces, redevelop reports and retrain users. The system changes will affect nurses, physicians, patient financial services, case management, utilization review and other staff in addition to coders.

"The ICD-10 code set will give providers more granular information that will, in turn, allow us to better tell the patient's story," CHIME wrote. "This will lead to better outcomes for patients and increased innovation for the healthcare delivery system as a whole."

The group "implored" HHS to focus on changing ICD-10 "codes that matter and leaving aside those that do not."

The health IT organization said that if HHS insists on staggered compliance dates, meaning different deadlines for physicians and hospitals, then insurance companies should have their compliance date set in advance so that there's an opportunity to test the ICD-10 coding in transaction systems.

"We also issue a final word of caution," CHIME wrote. "If the postponement process requires physicians to meet one compliance date and hospitals a different date, unnecessary costs will be incurred. In order for the ICD-10 conversion to go as smoothly as possible, all segments of the provider community need to be in lockstep."

Lucas Mearian covers storage, disaster recovery and business continuity, financial services infrastructure and health care IT for Computerworld. Follow Lucas on Twitter at @lucasmearian or subscribe to Lucas's RSS feed . His e-mail address is .

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Copyright © 2012 IDG Communications, Inc.

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