ICD 9 to ICD 10 Regulations and Standards - Benefits and Challenges - Article Example

It was first instituted in the mid 1970’s and is therefore almost forty years old. Along with being outdated, the codes for the older editions are at maximum capacity. Technically, the United States will be almost the last developed country to fully embrace ICD 10, as it had been in use in many countries since 1993. Actually it will be known in this country as ICD 10-CM, due to changes made to the version. The change from nine to ten was also necessitated by the increasing evolvement of informatics.

Where edition nine can only utilize 13,600 volumes of code, ICD 10-CM can handle 69,000, an increase of over five hundred per cent (AAPC, 2012). Discussion Besides the added capacity of ICD 10-CM, there are various benefits it offers. First of all, part of the reason for the increased volume is the difference in the size of codes between the two. Nine has no more than five characters and is alpha numeric but only uses E or V (only in digit 1). ICD-10 has up to seven characters and is likewise alpha numeric but the difference is the alpha character can be any letter, first or last position.

The Centers for Medicare and Medicaid Services (2010) defines the benefits (among others) as the ability to have a measurement device for care and efficiency, preventing public health risks (such as communicable diseases), streamlining payment devices, tracking and stopping fraud, and conducting policy and research. The attachments required by ICD-9 to diagnose a patient will also be greatly reduced in ten. With benefits of a new system there are also always challenges involved. First are the financial and resource liabilities payers will face for implementation, as it “will be a complex and painstaking process” (Thompson, 2011).

Another problem for payers and health care staff alike is the training involved, both for the time constraints involved and moneys expended. Like Thompson points out however, training is tantamount, for health Workers entering the wrong codes could be disastrous and also result in delayed payments for their entity. Also, certain private payers such as Workmen’s Comp insurers are not required to transition to ICD 10-CM. So providers will have to face the economic and logistical nightmare of operating two different versions.

Actually Kathleen Sebelius, the Secretary of US Department of Health and Human Services (HHS) announced earlier this year that the deadline for ICD 10-CM has been extended for one year, until October 1, 2014. So hospitals have some breathing room. Cumberland Consulting Group specializes in helping healthcare facilities employ new technologies such as ICD 10-CM. Their Amanda Brenegan in an unbiased report on ten (Herman, 2012) points out over forty per cent of hospitals at least have a plan of implementation and many have already started the laborious process of training physicians and staff.

However, she is critical in stating that the training is probably lacking, as most trainees don’t understand the concept of ICD 10-CM. Another hurdle facing hospitals is having to undergo too many transitions at once. Electronic Health Records (EHR) has already surpassed its October 3, 2012 deadline for incentive payments due to early implementation. In February of this year the National Institutes of Health (NIH) published a roadmap to help with the interaction of ICD 10-CM and the Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT), which had been adopted by eighteen countries, including the US, Australia and Denmark.