Patient Centered Care WG meeting, 7 August 2013

We had a discussion of the perils and pitfalls of the transition to ICD-10 codes, mandated to be complete by October 1 2014. So far, the consensus is that there are more questions than answers, and very little real progress in figuring out how eat this particular elephant. The biggest pain points are the time it will take to input accurate codes - or translate somewhat vague ICD-9 codes into [excruciatingly, in some cases] specific ICD-10 codes - and the high likelihood that there will be major delays and disruption in the billing and reimbursement processes. And those don't even begin to touch the problem of modifying EHR code to accept, interpret, and respond appropriately to a completely different and much more complex coding system. The [long-term] advantages are that the specificity of the code will simplify decision support requirements and also support healthcare quality initiatives, identification of diagnosis trends, public health needs, epidemic outbreaks, and bioterrorism events. It will also make sharing medical data across national borders electronically more reliable.

The need for tools to make the transition easier is clear. Some needs are: billing 'scrubber' to make sure that ICD-9 codes are removed and replaced by ICD-10 equivalencies; translation tools to provide equivalency choices; new encounter templates tailored to the diagnosis detail required by ICD-10; CPT to ICD-10 mappings. Above all, because this change will affect every provider, patient, and payer, we need transparency and cooperation to insure that everything still works at least as well as it does now after the transition date.

I have included my PowerPoint deck, below, and a number of links to other resources.