The ICD-10 rollercoaster rolls along

What an up-and-down, fast-and-slow, twisting, turning run ICD-10 has been on over the past four seasons.

Last spring and summer, as Oct. 1 drew closer—that date representing the last in a long line of postponed launch plans—the expanded medical-coding system was met with all sorts of resistance.

Among the most conspicuous efforts to derail or further delay the inevitable were Texas Rep. Ted Poe’s Cutting Costly Codes Act of 2015, the American Medical Association’s endorsement of Poe’s bill and Tenn. Rep. Diane Black’s bill to keep the Oct. 1 kickoff but allow an 18-month grace period.

Then October 1, 2015, arrived. The 10th revision of the International Statistical Classification of Diseases finally took off. And as the weeks went by, the ICD-10 rollercoaster rocked as well as it rolled.

• On Oct. 29, Clinical Innovation + Technology reported that, based on the first numbers from CMS, the transition to ICD-10 was going well.
• On Nov. 17, we chronicled an analysis showing that the transition was hurting coder productivity at hospitals.
• On Dec. 1, we noted a survey from Big Four auditor KPMG showing that some 11 percent of healthcare providers had called ICD-10 a failure.

Here’s the thing. Loved or loathed, this ride isn’t stopping. Can’t we all just go along to get along? After all, people are resilient. We can get used to just about anything. Sooner or later, the new way just becomes your life. Could it be that’s what’s really happening right now?

Well, sort of, says Holly Louie, RN, chair of the ICD-10 committee of the Healthcare Billing and Management Association.

“Claims are processing, providers are being paid, denials are minimal; it was all much ado about nothing,” Louie blogged Jan. 18. “Or was it? For some unlucky practices and organizations, things did not (and are not) going quite so well.”

I spoke with an industry insider a few days ago, one whose firm has been in medical billing and revenue cycle management for decades. This keen observer is absolutely upbeat about where ICD-10 is helping to take healthcare—think the Institute for Healthcare Improvement’s “triple aim”—and is especially bullish on radiology.

“The more information you can get about how something happened, and what specifically happened, the better able you are to take care of your patients and the sooner and more completely you’re going to get paid,” the insider reminded me. “Radiology is already doing a lot of this. It won’t be a big leap to get to the second piece”—that being ICD-10’s promise of delivering detailed big data to improve U.S. population health.

Rollercoaster? Next time we’re going to need a bigger metaphor.