HHS Nails Down Delay of Controversial ICD-10

August 24, 2012

August 24, 2012 — As expected, physicians will not need to start using a new and controversial set of diagnostic codes called ICD-10 until October 1, 2014, a year later than originally scheduled, the US Department of Health and Human Services (HHS) announced today.

The 1-year delay, first proposed by HHS in April and now nailed down in final regulations, comes in response to complaints by organized medicine about the administrative burden of converting to ICD-10. The American Medical Association and other medical societies told HHS that converting to the more voluminous and complicated set of diagnostic codes could cost medical practices tens of thousands of dollars and interfere with their migration to electronic health records and electronic prescribing. These groups have called on HHS to come up with a simpler replacement for the current set of diagnostic codes — called ICD-9 — now in use.

ICD-10 stands for the International Statistical Classification of Diseases and Related Health Problems, 10th Revision. The Centers for Medicare and Medicaid Services (CMS) mandated the switch from ICD-9 to ICD-10 as part of implementing the Health Insurance Portability and Accountability Act. HHS considers ICD-9 outdated and imprecise.

ICD-10 contains 68,000 diagnosis codes, which is roughly 5 times the number in ICD-9. The new codes also run to a maximum of 7 characters compared with 5 in the current codes.

Some of the unpopularity of ICD-10 stems from the inclusion of codes that describe arcane medical problems. There are diagnostic codes for getting bitten by a duck, walking into a lamppost, and getting burned by blazing water skis. However, the painstaking complexity of the codes translates into obvious clinical benefits, such as specifying a more exact location of a neoplasm, for example.

The HHS regulations announced today also established a standard format for health plan identifier (HPID) codes that is designed to simplify billing for clinicians and hospitals. Identifiers for health plans now in use differ in format, and that variety invites errors, leading to misrouted transactions, rejected claims, and problems determining patient eligibility, according to HHS. The department estimates that implementing a standard HPID will save the healthcare industry up to $6 billion over the course of 10 years.

More information about today's announcement regarding ICD-10 and a standard HPID is available on the CMS Web site.


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