CMS Silence on ICD-10 Holds Healthcare Hostage

Scott Mace, for HealthLeaders Media , April 8, 2014

But after talking to Battani and Lance, this just looks like an extended hurricane season for healthcare IT.

"I don't know how much experience you have with doing very big projects, but it's very hard to slow them down and stay effective and focused and hit a revised deadline," Battani told me.

"In some ways it's almost easier when you're doing a big project when it's just cancelled. Then you just dismantle all the apparatus and you move on to other things, but the challenge that these organizations will be facing now is how to maintain organizational focus and be ready to ramp up again when the new deadline is disclosed, and that sort of start/stop, continue activity is very, very difficult to optimize."

Battani also threw cold water on a strategy by which some providers would code to ICD-10 in the fall and then back-code to ICD-9 to continue to get paid.

"Here's the thing about payment," Battani said. "There's a lot of reimbursement schemes in ICD-9. When you're forced to use not-very-specific diagnosis information, those claims require additional documentation to be submitted in order to get paid. That's a process that's incompletely automated, so there are problems in the reimbursement process that ICD-10 is a useful tool for helping to fix, streamline, and optimize payment."

In addition, "whenever you're using crosswalks, that creates another opportunity for appeals and disputes about reimbursements, because there's endless argument about did you crosswalk it to the right thing," that's the case even going from ICD-10 back to ICD-9, Battani added.

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1 comments on "CMS Silence on ICD-10 Holds Healthcare Hostage"

Frank Poggio (4/8/2014 at 5:49 PM)
Developing and implementing systems such as ICD10 require structure and predictability. Politics requires neither. If our politicians had to do real work for a living instead of just jabbering and please their biggest lobby things would get done much faster and better. And as for that snide remark from Dr. M about no more perfect storm analogy, now its a perfect tsunami! If he's so smart he should have stayed in CMS and not run for the door when things started getting rough.




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