Waiting for ICD-11

The ICD-10 deadline is just months away. Meanwhile, ICD-11 is fast on its heels. It’s tempting to consider skipping over ICD-10 and just waiting for ICD-11. I get that. With as much change and increase in complexity as the transition from ICD-9 to ICD-10 means and the impact it has on your practice (coding, billing, quality management, training, infrastructure, more staff, more products)  I can only assume there’ll be at least an equal amount of change and increased complexity when moving to ICD-11. There’s a part of me that whispers, "Why do it all now just to do it all again in a few years?"

But the reality is, constant change, increasing complexity, and the need for more information are just part of the package when it comes to healthcare. Trying to float along and wait for the next big wave of change is going to leave you drowning.

According to the American Medical Association, there are compelling reasons to switch to ICD-10

First, ICD-9 is outdated. It offers only 13,000 codes. Compared to ICD-10’s 68,000+ codes and sub-codes, it’s clear that continuing to use ICD-9 limits your practice’s ability to improve the quality of care. ICD-10, on the other hand, is a faster and more efficient way to keep everyone at your organization on the same page. 

Next, implementing ICD-10 will build layers of knowledge and experience that will flatten the learning curve when implementing ICD-11. So, it won’t be like starting over from scratch when it’s time to adopt ICD-11.

Also, while it’s a valid statement that ICD-10 requires an investment of time and money to implement, it’s also a fair assumption that you’ll get less pushback from payers (fewer requests for additional information or “attachments”), since they have vastly more information at their fingertips.

The American Health Information Management Association warns that glossing over ICD-10 and waiting it out for ICD-11 is a risky move. Transitioning directly from 9 to 11 would be “much more complicated and disruptive.” Furthermore, they estimate that ICD-11 likely won’t be able to implement in the US for another ten years. In my opinion, that’s a decade too long to hang on to an obsolete data structure that will only erode your ability to improve healthcare quality. 

The bottom line is - adopting ICD 10 is a necessity in a world that demands data, speed, and continuous improvement. (in addition to the obvious…ICD-10 adoption is a CMS mandate and in order to get paid, your organization has to switch).

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Tracey Meyer

About the Author
Tracey Meyer

Tracey Meyer is responsible for all symplr software product management, and was in the Cactus Software product development group for 2 years before being selected to helm the product management team for symplr. She brings 20 years of business and technical software experience building products to simplify and enhance the user experience for her clients.

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