ICD-10: Mandate and Opportunity

Marianne Aiello, for HealthLeaders Media , November 13, 2011
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This article appears in the November 2011 issue of HealthLeaders magazine.

As the clock continues to tick down toward October 2013, when ICD-10 takes effect, hospital leaders are hopeful that the coding changes will result in improved quality of care. Still, many remain wary of the inevitable learning curve that comes with the mandate.

In the long run, the increased specificity of the coding structure will enable physicians to better tailor patient care, says Greg Walton, CIO of El Camino Hospital in Mountain View, CA. But in the short term, it will cause problems and communication confusion, he says.

“The level of details required and the amount of change is laced with a massive learning curve,” he says. “Mistakes are always made during large change periods. Moreover, frustration rises with change and that, too, leads to confusion and errors.”

When ICD-10 takes effect, the number of procedure and diagnostic codes will jump from 4,000 and 14,000 to 72,000 and 69,000, respectively. The codes themselves will change from a five-digit numeric code to a seven-digit alphanumeric code. As a result, documentation and coding will become extremely specific. For example, under ICD-9 there is one code for any type of artery suture. Under ICD-10, there will be 195.

For more than one year, the 542-licensed-bed El Camino Hospital has had an ICD-10 task force working on implementation efforts. Hospital leaders plan to operate both ICD-9 and ICD-10 for about 18 months before
the mandate.

Walton believes that it will take about five years for the United States healthcare sector to realize the benefits of the mandate.

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