Why another ICD-10 delay could threaten national security

Though some medical groups keep pushing for yet another delay in ICD-10, Juliet Santos of consultancy Leidos Health, argues that another delay could be a threat to national security.

Santos, in an article at ICD-10 Monitor, says another delay could hobble the United States in the public surveillance of deadly health threats.

"Sicknesses and plagues have become weapons in modern-day warfare. Weaponized bioterrorism is rampant in other countries. ... We cannot prevent, monitor, track, manage, and control what we cannot see or find," Santos writes, mentioning ICD-9's non-specific and sometimes missing codes.

The new coding system will allow the U.S. to respond better to deadly outbreaks such as Ebola, she says. Although the specificity of ICD-10 has been the brunt of jokes--it includes nine different codes reflecting injury inflicted by a turkey--in ICD-9, Ebola is classified as 078.89, Other specified diseases due to viruses, a designation used for multiple viral diseases that have not been assigned a specific code. In ICD-10, it would have its own code--A98.4, Ebola.

"ICD-10 allows us to track and monitor patients with diseases similar to Ebola, because the codes are specific, the severity of illness is detailed, and we can determine illness rates as well as death rates," Santos writes.

Among the other reasons she advocates for the new code set: physicians are asking for new codes and ICD-9 doesn't have the capacity to add them. Without ICD-10, the return on investment in electronic health records and health data exchanges will be greatly diminished. Another delay, she says, will substantially add to healthcare organizations' implementation costs.

So far, the date for ICD-10 implementation is holding fast for Oct. 1, 2015. The American Medical Association has made ICD-10 one of its top issues for 2015, and the Centers for Medicare & Medicaid Services announced dates for the ICD-10 end-to-end testing period for providers.

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