Inside View of Incorporating ICD 10 Diagnostic codes, mandated by Obamacare

side effects obamacare The reality of little time and the humongous task of incorporating the new ICD-10 Diagnostic Codes, is upon the entire healthcare field. The only analogy I can present to those of you not having any idea of what I’m referring to, is kind of like having been told you have a terminal illness and you’re now preparing for the biggest fight of your life.ICD 10 codes are a list of numerical codes used for the purpose of International Statistical Classification of Diseases and related Health problems and put out by the World Health Organization. It is composed of 2 sets of codes; 1 for diagnosis and 1 for procedures.  Per Robert Lowes (Med News Nov 2011) Medscape Medical news, “The Centers for Medicare and Medicaid Services (CMS) decreed the switch to ICD-10 in 2009 as part of implementing the Health Insurance Portability and Accountability Act (HIPAA). The rationale is that ICD-9, now 30+ years old, contained outdated and obsolete terms, captured limited data about a patient’s condition, and failed to describe current medical practice. Plus, its structure limited the number of new codes that can be coined.” ICD 10 codes are already prevalent around the world by industrialized countries, as well as many developing countries,  such as Australia, Canada, France, Germany, South Korea, Netherlands, Sweden and Thailand, to name a few. The switch from ICD 9 to ICD 10 was inevitable.”

Per Robert Lowes, Medscape Medical News Nov 2011- ‘ICD-10 Is No Laughing Matter, Duck Bites Aside,’ “The new diagnostic codes are 3-7 characters in length, whereas their ICD-9 counterparts contain 5 at most.” This in itself, allows for more specificity in diagnostic descriptions. “Then there is the difference in the sheer volume of codes — 68,000 for ICD-10 compared with 14,000 for ICD-9.” Many Medical coding organizations recommended that training for all medical personal, vendors and payers start in 2009, but as per Mr Lowes Nov 2011 article stated,”only 9% of the KLAS study group (providers in hospitals and large health systems) were even 1/2 of the way through in the training process and the rest, in the early stage of their training. He also mentioned that private practitioners, who weren’t included in the study, are even less prepared.”

Mr Lowe, Medscape Med News Nov 2011, went on to state that “even with software vendors doing their part on the tech end, physicians still have to invest sufficient time and money in training themselves and their staff — especially professional coders — on how to use the new diagnostic codes. Sources of that schooling range from software vendors to practice-management consultants to a network of ICD-10 trainers approved by the American Health Information Management Association (AHIMA).” The Medical Group Management Association (MGMA) estimated in 2008 that a 3-physician practice would shell out a grand total of $84,000 to implement the new code set. Not to forget to remind all that decreased reimbursements are very much a factor in the equation as well.

“We’re seeing a lot of (CFOs) put their head in the sand,” said Mike Koehler, a director in the risk practice of solutions firm Crowe Horwath. “We’re seeing tremendous failure on an organizational level.”Ms. Rene Letourneau 8/8/12 ‘Smart CFO’s Keep Focus on ICD-10;’ “We’ve talked to a lot of CFOs who are now saying ‘this is complicated. This is a huge operational change.This is a house-wide initiative,’” said Koehler. “What’s going to happen is the ones who were asleep at the switch are going to have this pass them by. We see some institutions that are not going to be around. They are just not going to have the wherewithal.”

I’m hoping this article leaves everyone with the sensation of being overwhelmed, which is clearly how the majority of healthcare professionals feel. In addition to the new code sets, there is the mandate for incorporation of Electronic Health Records, Incorporation of meaningful use (The American Recovery and Reinvestment Act of 2009 authorized the Centers for Medicare & Medicaid Services (CMS) to provide incentive payments to eligible professionals (EPs) and hospitals who adopt, implement, upgrade, or demonstrate meaningful use of certified electronic health record (EHR) technology,) New HIPAA regulations in regards to patient privacy, as well as trying to find funds to pay for IT to keep the system running and lastly, train staff in all of the above. Without all this incorporated, a healthcare professional can’t bill out or be paid.

I heard a statement from Betsy McCaughey (attorney and think tank scholar) this afternoon while listening to the radio, in what to expect from the upcoming Obamacare. She said that the cost of healthcare related paperwork alone, was around 19 billion when Pres. George Bush was in office and will go up to around 60+ billion when Obamacare takes over 2014. This increased burden secondary to the paperwork generated by meaningful use, will in my opinion, only serve to bog down the healthcare system and yet, at the same time, the system will be expected to take on the additional 30 million people Obamacare will add. All this in a country that has no money. I don’t mean to be disrespectful, but common sense has left the building! What do you think?–an Industry you’re excited to go to work in or maybe a new theme for a Sci-Fi movie-? God help us all!!!

LINK to AMA ICD-10 diagnostic codes

 

Comments

  1. Realize that the push for ICD 10 codes started years ago with Hilary’s attempt to socialize healthcare.

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