ICD-10 reinvents classification of diseases in the U.S.

The next revision of the international classification of diseases codes from the World Health Organization is two years away from implementation, but already it looms large in the minds of our nation’s health care providers from coast to coast.

“It is a huge, transformative initiative, and the whole country is going live on the same day,” says Peggy Lynahan, manager of the ICD-10 program at Christiana Care. “It’s like health care’s own Y2K.”

Starting Oct. 1, 2013, the next (10th) revision of the codes, ICD-10, will be required for claims by everyone covered by the Health Insurance Portability and Accountability Act (HIPAA), not just for Medicare patients. That means codes for medical diagnosis, both inpatient and ambulatory, and inpatient procedures must be according to ICD-10.

ICD-10 is already the coding system in place for claims and transactions in 25 other developed countries, including most of Europe, Canada, Australia and Thailand.

“This will enable the United States to be in a position to share information relating to disease and morbidity statistics with other countries in more specific ways,” Lynahan says.

In other countries, codes refer only to diagnosis. In the U.S., in addition to diagnosis, there will be codes for inpatient procedures.

Christiana Care has been preparing for the transition for two years, completing an impact assessment and laying the groundwork for the new system.

“ICD-10 will be a transformative change in health care that will enable us to better measure the quality, safety and efficacy of the care we deliver,” says Sharon Anderson, senior vice president for Quality and Patient Safety.

Formally known as the The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, ICD-10 will enable health care systems to track many new diagnoses, allowing more than 155,000 different codes. Improving the quality and quantity of data will help to improve quality measurement and outcomes, public health, research, monitoring and reimbursement.

Health care providers will not be able to submit ICD-9 codes for services provided on or after Oct. 1, 2013, according to the Centers for Medicare and Medicaid Services. Conversely, providers cannot implement ICD-10 before that date, even if their systems are in place.

Lynahan believes it is highly unlikely that deadline will be extended. “CMS is giving clear indications that they are not moving this date back,” she says. “When it is time to make the change, we will be ready.”