ICD-10: After the Thaw
July 27, 2015 | Rhonda Butler
If you have the slightest inclination to freak out about ICD-10 because change makes you nervous, please ignore this blog.
Okay, now for the rest of you: the code sets have been frozen for more years than is good for them, and once we get to “thaw” the code sets, they need to be updated. How can that be, you say? ICD-10-CM/PCS is brand spanking new. No, not exactly—not new, unused. New and unused are not the same thing. Putting meat in the freezer does not make it fresh—it lets you put off cooking it for a while.
ICD-10 has been in a regulatory deep freeze for four years, but it has been in a philosophical, intellectual deep freeze for far longer than that. The ICD-10-PCS procedure set was first released in 1998 and the ICD-10-CM diagnosis set was released in 2003. There were regular updates since that time, but until recently they were mostly to ensure that ICD-10-CM/PCS did not lag behind ICD-9-CM or the WHO version of ICD-10. That is all anybody could afford to do under the circumstances.
In the last few years, the people who normally participate in updating a code set have finally been able to invest the time in ICD-10, and so there has been a significant increase in the number of requests for new codes and other changes to the system. The requests come mainly from the medical specialty societies who care about having good diagnosis codes for research and the inventors of new surgical techniques, equipment and devices who want to be able to track their efficacy.
The coding professionals in the community are also submitting requests for change. Now that a significant number of providers are coding records in both ICD-9 and ICD-10, coders are reporting to CMS and NCHS/CDC the little errors and inconsistencies in the index, coding instruction, and the codes themselves that inevitably surface only under this kind of testing. (You know how hard it is to find your own typos—same deal). T
hese proposals have been presented during the freeze years, at the twice annual public meetings of the ICD-10 Coordination and Maintenance Committee. Many proposals for change have received public support and are ready to be added to the code set after the thaw.
This is all good, and what is supposed to happen. ICD-10 is ready to be thawed out so that it can be updated annually, to stay current as the understanding of disease and the technologies of treatment continue to change. ICD-10 is required to stay in the deep freeze for the first year of implementation, but then it needs to thaw. Frozen stuff does not last forever. It’s time to get cooking with ICD-10.
Rhonda Butler is a senior clinical research analyst with 3M Health Information Systems.