No crosswalk from ICD-9, but ICD-10 is on track for October
Friday, February 13, 2015
The "delay ICD-10" proponents have found themselves another piece of ammunition to use in their war against transitioning from the current ICD-9 coding system. The latest development in the never-ending fight against replacing the decades-old version is a new study from Vanderbilt University that suggests that mapping codes between ICD-9 and ICD-10 could be a problem.
New data published in the Journal of the American Informatics Association reviewed 100 patient visits to the Vanderbilt Adult Primary Care Clinic. Visits coded manually with both ICD-9 and ICD-10 did not match when compared with general equivalence mappings and reimbursement mappings.
The study found that "while the GEMs/RMs were consistent with manual encodings more than 80 percent of the time in both directions, a significant fraction of manual mappings were inconsistent with the GEMs and RMs," FierceHealthIT reports.
Of those mismatched mappings consisting of only one ICD-9 and one ICD-10 code, at least half did not match the GEMs because of "subtle" differences within the same hierarchical category, according to the research.
"These results should reinforce the notion that no true crosswalk exists between ICD-9 and ICD-10," the study authors wrote. "Whether this consistency rate is sufficiently high to avoid significant changes in reimbursements or public health statistics is beyond the scope of this study."
However, despite this information, Healthcare IT News is reporting that ICD-10 likely will move forward in October.
"After years of angst and multiple delays, comes a government report that indicates the Centers for Medicare & Medicaid have done the necessary testing to move forward," according to the interpretations of Senate Finance Committee Chairman Orrin Hatch (R-Utah) and Ranking Member Ron Wyden (D-Ore.) of the Government Accountability Office report released Feb. 6.
As the magazine so aptly recalls, however, there's nothing to suggest that this "news" is anything more than lip service. The same was said to have been the case last year, when ICD-10 was supposed to have been implemented on Oct. 1, 2014, but was pushed back at least a year to Oct. 1, 2015.
In a statement reported by Medscape, Hatch said, "I will continue to keep a close eye on the issue, but see no reason for any delay past the October deadline." The medical societies of Texas and New York have lobbied to delay, again, the ICD-10 implementation date to October 2017.
ICD-10 is supposed to replace ICD-9, as required by the Health Insurance Portability and Accountability Act. The new set has 68,000 diagnostic codes, five times the current version. Those in favor of ICD-10 "say the new codes are better able to accommodate new diagnoses and procedures in medicine," Medscape reported.
"In addition, ICD-10 allows physicians the ability to indicate the location of a wound, tumor or condition. Many medical societies, however, contend that ICD-10 will cost physicians tens of thousands of dollars in terms of training, implementation, software upgrades and disrupted claims processing. And they do not expect patient care to improve, either," Medscape states.
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