Hospital execs: Why dual ICD-9, ICD-10 coding is equivalent to another delay

Advocating dual coding as a means to protect small physician offices from inadequate preparation for ICD-10 amounts to another delay in implementing the new code set, asserts the Coalition for ICD-10.

The coalition--which includes the College of Healthcare Information Management Executives, the American Healthcare Information Management Association, the American Hospital Association, the American Medical Informatics Association and America's Health Insurance Plans, among others--maintains that dual coding is unworkable, confusing, costly and unnecessary. It adds that even the Centers for Medicare & Medicaid Services has come out against it as an unfeasible approach.

Among its arguments:

  • Dual coding would require complex and costly changes to major payment, clearinghouse and provider systems
  • The code system is used not just for billing, but also among providers for testing, prescribing and referring. The two sides would no longer be speaking the same language
  • It would interfere with the ability to effectively analyze costs, outcomes of care and patient safety
  • Payment, clearinghouse and provider systems involved claims over time and across providers would have to be rewritten to allow all possible combinations of mixed ICD-9 and ICD-10 claims

The biggest impediment to physician readiness to transition to ICD-10 remains uncertainty that the government will hold fast to the Oct. 1 deadline, according to the coalition. After two previous delays, the transition to ICD-10 resembles the children's game "Red Light, Green Light," Brett LeFevre, an associate at Salt Lake City-based healthcare consulting firm Leavitt Partners, wrote last summer in in a post for the Health Affairs Blog.

Many members of the House Energy and Commerce Committee's Subcommittee on Health in February made clear they oppose another delay. Still, Congress is expected this month to attempt a permanent fix to the Medicare Sustainable Growth Rate formula for reimbursing physicians, which could open the possibility that another ICD-10 delay could be added as an amendment, Health Data Management reports.

To learn more:
- find the article
- read the Health Data Management piece