Heritage Foundation, Coalition for ICD-10 Face Off on Coding Changes

June 8, 2015 in News

On Friday, the Coalition for ICD-10 in a release refuted claims made in a recent Heritage Foundation report that argued against the mandatory adoption of ICD-10, Healthcare IT News reports (Sullivan, Healthcare IT News, 6/5).

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures by Oct. 1.

Details of Heritage Report

The Heritage report argued that the ICD-10 transition “will add to the already considerable financial and administrative burdens on physician practices.”

The report called for the development of a “more appropriate coding system that makes the billing process less, not more, burdensome.” It also called for Congress to “delink the disease classification system from reimbursement policy, and make the adoption of the new ICD-10 code system voluntary until a less burdensome billing process is in place.”

Further, the report stated that transitioning to ICD-10 would be costly to providers and that the resulting “productivity losses and reimbursement disruptions … will have a lasting adverse impact on the quality and cost” of care.

The report stated that a “substantial portion of the physician workforce” does not have adequate time or resources for the transition, adding that most providers “believe that ICD-10 will adversely impact health care, and do not support its implementation.”

The report also ¬†argued that state governments and health insurers will face a “less direct” burden than providers but that “the cost experienced by these entities will still have a significant impact on health care quality and cost” (Grimsley/O’Shea, Heritage Foundation report, 5/18).

ICD-10 Coalition Response

In its response to the report, the Coalition for ICD-10 argued that developing a different coding system would prove more costly than the transition to ICD-10 (Healthcare IT News, 6/5).

The coalition stated that the Heritage report’s proposals “would not only result in the loss of enormous investments that have already been made, but would require extraordinary additional investments.”

The group noted that in the most recent round of CMS end-to-end ICD-10 testing, “only 2% [of codes] were rejected due to ICD-10-related errors — less than the rejection rate following the annual ICD-9-CM code changes.”

In addition, creating another coding system would require providers to use two separate coding systems because ICD would still have to be used for international disease reporting requirements, according to the coalition. The group added, “Even more troubling, the communication of health information between providers would be compromised” by the use of two separate coding systems.

Meanwhile, the coalition argued that “there is a long history of extensive involvement and support by physician groups throughout ICD-10-CM development” and that “much of the additional clinical detail in ICD-10 was recommended by physician groups” (Coalition for ICD-10 response, 6/5).

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