The 80th American Health Information Management Association convention officially opened Monday in Seattle with an eye on the future.
One huge challenge looming for the healthcare industry, and one close to home for AHIMA members who deal with coding of medical records, is the proposed and long-awaited upgrade of the International Classification of Diseases coding system.
On Aug. 15, HHS released a proposed rule to amend the Health Insurance Portability and Accountability Act and require all HIPAA-covered organizations to switch to ICD-10 CM codes for diagnosis and the ICD-10-PCS (procedure coding system) codes for inpatient hospital procedures. The new code sets would replace the ICD-9 series used in the U.S. but supplanted long ago elsewhere.
At the same time, HHS released a second proposed rule covering the rollout of updates to data transmission standards by the Accredited Standards Committee called ASC X12 Version 5010, a conversion needed to carry the ICD-10 codes. The compliance deadline for the switch to ICD-10 is Oct. 1, 2011. The deadline for conversion to 5010 is April 1, 2010.
At a news conference Monday, AHIMA leaders announced the organization would coordinate a national summit on the ICD-10 conversion sometime next summer or fall. No site has been specified, although Chicago, where AHIMA is headquartered, is a likely location, according to AHIMA officials.
Linda Kloss, AHIMAs chief executive officer, said the switch to ICD-10 was long overdue. In fact, were a decade behind the rest of the world. Now, we understand that the bridge we build between the promise of ICD-10 today and the ICD-10 systems we can implement in three years will be an integrated and complex undertaking. That is why AHIMA has already begun preparing the strategic processes required to move our healthcare system from here to there.
That was about as close as AHIMA officials got to embracing the government timeline of an Oct. 1, 2011, ICD-10 rollout, which others criticized as being overly ambitious. After the proposed rule was released, a coalition of providers and payers said the pace was too swift, with Robert Tennant, senior policy adviser for the Medical Group Management Association, saying that the simultaneous rollout of ASC X12 5010 with ICD-10 is contrary to earlier recommendations by the National Committee on Vital and Health Statistics for a staged adoption with 5010 first, then ICD-10. Tennant called the government timetable a framework for disaster.
Jill Dennis, AHIMA senior vice president for advocacy and practice leadership, pledged that AHIMA will serve as a resource on the ICD-10 conversion for the entire healthcare industry. Our goal is to make AHIMAs ICD-10 Web site a key resource for anyone preparing for this transition. AHIMA is gearing up to offer training, not only to coders, but to others who have to plan for the transition and use the codes.
What AHIMA officials were more emphatic about in regards to timing was not when the deadline was set, but that any deadline for compliance is met because of training costs.
Dennis said AHIMA research shows that training too soon is a bad idea that were going to advise healthcare organizations and physician practices to avoid because we know that this kind of training is more effective if its done relatively close to the implementation data, somewhere in the range of six to eight months before.
Dan Rode, AHIMA vice president for policy and government relations, said that it would be a bad thing to train thousands of coders and then have the deadline pushed back at the last minute, so a definite implementation date is a must. Rode said that AHIMA will work with others in the industry to ensure that everyone knows their steps to implementation.
HHS officials are trying to have the final rule for ICD-10 ready no later than Jan. 15, 2009, Rode said.
One of those steps that needs to be taken for an ICD-10 rollout is to get the Certification Commission for Healthcare Information Technology onboard.
For now, CCHIT has not included ICD-10 coding in its testing criteria for any of the clinical IT products it tests for certification, according to commission Chairman Mark Leavitt.
Leavitt hosted a town hall meeting at the convention Monday. Regarding ICD-10 promotion, however, CCHIT wont be able to join the bandwagon by formally adding ICD-10 capability to any of its testing criteria next year, and it may not make it for 2010 either.
Leavitt said that under normal circumstances, CCHIT wants to signal IT system vendors and customers what is coming in the future by placing proposed new criteria on what it calls its road map column of its criteria listings as they are developed each cycle. Under normal circumstances, those road map criteria would then be made public 18 months before they will be used to test IT systems.
That means ICD-10 would need to be added by this December to criteria under development for use in 2009 if ICD-10 is to become a test function in the summer of 2010. Leavitt said that a first draft of the new 2009 criteria and other future road map criteria is already out for its public comment period, which will remain open through Oct. 28. It is possible that ICD-10 could be added by December, he said.
Another way for ICD-10 to jump that 18-month road map requirement is if the CCHIT board takes the extraordinary step of pushing the criteria ahead of the normal development cycle, according to Leavitt.
What the group might do is to put it on the road map for 2011, Leavitt said. Until now, though, Theres been so much push-back on it, we said, Lets wait and see.
Leavitt said CCHIT recently published a research report on the uptake of IT incentive programs. According to the report, there are more than 40 financial incentive programs in existence as well as more than 50 IT subsidy programs to physicians under the federal Stark and anti-kickback waivers of 2006. Combined, there are more than $700 million in incentives for health IT that have been announced since CCHITs certification program was launched, and that excludes CMS incentives that include quality reporting as well as IT use.
We were actually surprised that much more has happened than we actually ever thought would have happened, Leavitt said. Im not going to say its only because of certification, but as a result of certification plus all the things that have been going on.
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