It's Time to Move to ICD-10, Not for Another Delay

It's no secret that when the federal government announced a one-year delay in implementing ICD-10, many healthcare providers were not pleased with the news. When the delay was announced, organizations across the country had already made significant strides to prepare for the change, and this delay only hindered their forward momentum.

At Atrius Health, the Northeast’s largest nonprofit independent multi-specialty medical group serving 675,000 adult and pediatric patients, we assumed that ICD-10 would still happen. So we continued to move forward with preparation for the switch. It was our belief that stopping implementation and then re-starting the effort later would be inefficient and expensive.

Over the last year, we've continued to push forward with preparing for implementation. At this stage, Atrius Health is well positioned to go live with ICD-10. Last year, we changed all of our front-end systems to ICD-10 to familiarize providers and give them time to adjust to a new system, while information is converted back to ICD-9 on the back end so claims are billed properly. Additionally, we partnered with the Massachusetts Health Data Consortium, along with Massachusetts'

largest private insurers and providers, to test and troubleshoot ICD-10 through a unified testing platform. This testing platform has allowed us to ensure that a submitted claim will be correctly adjudicated on the insurer side. The collaboration created a common learning environment for providers and insurers to see which types of transactions were failing and to address those problems. Because of this uniquely collaborative experience, the majority of the problems providers and insurers encountered have been rectified.

We're in an advantageous position; others are not so fortunate. With just eight months to go until the launch of ICD-10, those organizations that used the delay to slow their preparations have a lot of ground to cover before the Oct. 1, 2015, launch. And with CMS end-to-end testing set for this spring, just six months before the launch, there won't be much time to thoroughly address major problems with a program of this size. There is still a great deal of uncertainty in the healthcare community about what is going to happen with ICD-10, especially with recent staffing changes at CMS.

But is another delay of ICD-10 the solution? Absolutely not. We've already seen that organizations that were falling behind before the delay haven't taken the extra time to get up to speed. Additional time to prepare isn't likely to motivate them to any more than the first delay did. While it would have been wise for the government to move forward with an Oct. 1, 2014, launch - or perhaps skip ICD-10 altogether and wait for ICD-11 - halting implementation now would be a huge burden to the industry. It's not time for another delay; it's time to get to work.

Michael A. Lee MD, MBA, is the director of clinical informatics at Atrius Health and a pediatrician at Dedham Medical Associates, an affiliate of Atrius Health, where he has practiced since 1991. Lee received his medical degree from McGill University and completed his internship and residency in pediatrics at Tufts Medical Center. He also has an MBA from the University of Massachusetts. E-mail him here.