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Assessing the Impact of ICD-10

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For hospitals, making the transition to the new ICD-10 diagnosis and procedure codes could be a bigger task than addressing the Y2K bug. And the transition could be an important catalyst for replacing aging core information systems, says Stanley Padfield, system director for health information management at four-hospital Lee Memorial Health System, Cape Coral, Fla.

Some older information systems will be unable to accommodate the more complex ICD-10 codes that replace the ICD-9 version, Padfield contends. He points out that a wide variety of information systems, both clinical and financial, must be tweaked or replaced to use the new codes.

Hospitals and physician practices must move to ICD-10-CM diagnosis codes for documentation and billing for all payers by Oct. 1, 2013. Hospitals also must implement ICD-10-PCS procedure codes by that date, while clinics will continue to use CPT codes for procedures.

But Padfield stresses that there’s no reason to panic about ICD-10 because there’s plenty of time to prepare. “For Y2K, I sat at the hospital at midnight with my fingers crossed, and at 12:15 a.m. I went home because all went smoothly,” he recalls. The transition to ICD-10 can be equally uneventful with proper planning, he contends.

Nevertheless, Padfield says tackling the ICD-10 challenge will prove more difficult than Y2K “because there are a lot more variables involved.” Plus, providers that fail to adequately prepare risk not getting paid promptly by Medicare and other payers.

Lee Memorial has formed an ICD-10 project team. “We’re handling it like any other project,” Padfield says, pointing out the need for training as well as testing. The hospitals are phasing in new clinical and financial systems from Epic Systems Corp., Verona, Wis.

The delivery system uses a variety of coding applications from QuadraMed Corp., Reston, Va. Padfield is working closely with the vendor to make sure the hospitals can generate both ICD-9 and ICD-10 codes during the transition period.

Padfield made his comments in an interview at the American Health Information Management Association Convention in Grapevine, Texas.

--Howard Anderson

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