ICD-10 delay: Something else to debate

The clash over delaying the ICD-10 compliance deadline continues, pitting physicians against the HIT industry. See what has one group calling the situation "catastrophic."

The question of whether you’ll need to comply with ICD-10 next year is still unanswered, but the debate over the deadline delay announced last month continues.

One physicians’ group urged the Department of Health and Human Services (HHS) to go back to the drawing board with the ICD-10 implementation schedule, and an industry survey shows that further delays to the diagnostic code set would only increase costs.

In a letter to the HHS Secretary Kathleen Sebelius, Medical Group Management Association (MGMA) President and Chief Executive Officer Susan Turney, MD, wrote that “the adoption of ICD-10 should not be considered without a revised implementation process in place.

“ICD-10 is expected to be one of the most significant changes the physician practice community has ever undertaken,” Turney wrote, adding that the transition will “divert scarce intellectual, educational, and financial resources away from the adoption of [health information technology] and other more critical patient care-focused endeavors.”

Before ICD-10 implementation, Turney urged HHS to:

Complete a comprehensive cost-benefit analysis. An MGMA estimate from 2008 shows that an ICD-10 transition would cost $285,000 for a 10-physician practice, but the financial benefits are unclear.

Pilot-test ICD-10. The pilot project should include a wide range of practice types and sizes, small and large hospitals, providers in both electronic and paper health record settings, and safety net providers.

?Analyze the effect of overlapping initiatives. How will ICD-10 affect practices that already are managing federal mandates such as meaningful use, e-prescribing, and quality reporting programs?

Meanwhile, results from a small survey of healthcare professionals involved in their organizations' ICD-10 transition showed that two-thirds of them believe a delay will not improve readiness, and more than two-thirds say a 2-year delay would be either “potentially catastrophic” or “unrecoverable.”

Healthcare software firm Edifecs Inc. conducted the survey at an ICD-10 conference less than 48 hours after the delay announcement.

When asked what percentage cost effect a 1-year delay would have, nearly half of the 50 respondents said it would increase costs 11% to 25%, and another third of respondents said it would increase costs by half. Based on existing overall cost estimates for ICD-10 from multiple sources, a year-long delay in ICD-10 could cost the industry from $475 million to more than $4 billion, according to the firm.

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