Why move to ICD-10, if ICD-11 is on the horizon?

While the United States is already a decade behind the rest of the world in using the most up-to-date International Disease Classification system – ICD-10 – the alpha version of ICD-11 is due out later this year.

Some are wondering if it would be less time-consuming and more cost-efficient to jump from ICD-9 to ICD-11 when it comes out in 2014 – particularly since many healthcare providers may not even meet the Oct. 1, 2013 deadline for ICD-10 implementation.

Sue Bowman, director of coding policy and compliance for the American Health Information Management Association, doesn’t agree.

“ICD-10 is the pathway to ICD-11,” she said. “You have to treat it like you’re building a structure starting with a first floor. You can’t build a fourth one without constructing a second and third.”

“Health organizations first have to comply with ICD-10 by 2013, an enormous undertaking – and a mandate, no less – that a surprisingly large percentage of organizations have yet to really delve into,” said Tom Sullivan, the editor of the blog “The ICD-11 beta won't even be out by ICD-10 compliance day, and that’s if it’s on time. What’s more, ICD-10 will consume such resources that all but the most ICD aggressive organizations are too taxed to start toward ICD-11.”

While other countries use ICD to classify and document information, healthcare organizations in this country face a challenge in adopting newer versions of ICD to fit current HIPAA laws and billing codes. It makes for a slow-moving process because it can be so complicated, said Bowman.

“Most providers have meaningful use on their minds, not billing with ICD-10,” said Russ Rudish, a vice chairman and U.S. healthcare providers sector leader for Deloitte & Touche LLP. “Organizations just don’t have the money or manpower to worry about ICD-10, HIPAA 5010 and meaningful use all at once.”
Bowman sees things slightly differently.

“ICD-10 is critical to all the health initiatives,” she said. “There’s no point in doing any of that if the data that is being pushed out is in ICD-9 format.”

“A lot of people don’t realize that there aren’t national procedural coding processes in 10 and 11 – it only applies to the diagnosis system,” Bowman added. “It’s not as difficult (for hospitals and coders) to get a handle on it as portrayed. All versions look pretty similar. When it’s all said and done, they’ll be happier to have more detailed codes to support the clinical side.”

Software companies seem to be ready for ICD-10, according to Rudish, and insurance companies are next in line. But providers are almost clueless as to how to get ready for the transition from ICD-9.

The nation should not expect to move to ICD-11 until well after 2020, according to Bowman, assuming that an ICD-11 beta is produced around the 2014-2015 projection.

“Everyone in the industry should get started now,” she said. “You don’t know how much time you will need to actually make the transition without making an assessment. Some are putting it off.”