Home Health ICD-9/ICD-10 Alert

Published on Tue Jul 17, 2012 PDF

Physicians' group considers leap-frogging over ICD-10.

If you've been dreading the switch to ICD-10, you're not alone. The American Medical Association has been vocally opposed to adopting ICD-10 as the new diagnosis coding system. And now they're looking into a proposal that could leave ICD-10 in the dust.

Background: Not only did the AMA's House of Delegates vote last year to repeal ICD-10 (which the Centers for Medicare & Medicaid Services did not adopt), but the group also applauded the news earlier this year that ICD-10 may be delayed from its original implementation date of 2013.

Now the AMA has taken additional steps to express its disillusionment with ICD-10, announcing that its House of Delegates adopted a policy to evaluate ICD-11 as a potential "alternative" to replace ICD-9, an AMA news release noted.

"ICD-10 coding will create unnecessary and significant financial and administrative burdens for physicians," said AMA President-elect Dr. Ardis Dee Hoven in a June 19 statement. "It is critical to evaluate alternatives to ICD-9 that will make for a less cumbersome transition for physicians and allow physicians to focus on their primary priority -- patient care. AMA voted today to consider ICD-11 as a possible alternative. The policy also asks the AMA and other stakeholders, such as [CMS], to examine other options."

A home care consultant advocated considering this point in her recent comments on CMS's final rule delaying ICD-10. "Why not wait and do an update with the World Health Organization (WHO) ICD-11-CM?" asked Rose Kimball with home care billing company Med-Care

Administrative Services in Dallas in her comments. "This would allow the United States to not always be so far behind the rest of the 'forward thinking' industrialized countries. This further reduces the costs associated with two (2) changes necessitated in order to be in sync with WHO."

But waiting for ICD-11 may not make as much sense as it seems at first glance. "It took the US eight years to adapt the WHO version of ICD-10 and create ICD-10-CM for use in this country," the American Health Information Management Association (AHIMA) points out in a recent article.

"Regardless of the benefits of ICD-11, the US would need a national version to allow for the annual updating required by Congress and US stakeholders. Assuming that the development timeline for a national version or clinical modification of ICD-11 could be cut in half down to four years, it would then take an additional two years to get through the HIPAA rulemaking process. As with ICD-10-CM/PCS, the industry would want at least a three year period for converting systems to ICD-11," the AHIMA article says.

End result: "Assuming that ICD-11 becomes available on schedule from WHO in 2016, then the earliest the U.S. could move to ICD-11 would be 2025, or 13 years from now," the AHIMA article points out.

Stay tuned for developments in ICD-10 implementation.

Editor's note: Read the entire AHIMA response here: http://journal.ahima.org.