ICD-10, the major medical coding overhaul scheduled to be required by Medicare in 2013, has been compared with both Y2K and the coming of HIPAA in its impact on billing systems and health information technology in general. While it will enable all kinds of in-depth data analysis that is impossible with the current ICD-9 system, it promises to be a major project involving both reprogramming and reeducation.

Canada has been using ICD-10 since 1994 (along with the rest of the industrialized world), and Chris Wierz, who used to be a consultant with the Courtyard Group in Toronto, will discuss what the transition was like and what U.S. providers can learn from their counterparts to the North.  

Despite a single-payer system, the upheaval caused in Canada at the individual provider level was probably very similar to how it's going to be here, Wierz says. "No one has mapped all the places that these codes go, because they never had to before," she says.

Clinical and billing systems are riddled with places where ICD-9 must give way to much more specific ICD-10. One ICD-9 code might break down into 20 different ICD-10 codes, all of which are several digits longer. 

"Then you have the physicians who know 15 to 50 codes," and that's all they've ever needed, Wierz adds. "Now those same codes might turn into 200 or 300, and all the people who touch these codes need to be reeducated. I worry that people think of this as a back-office upgrade." Wierz plans to outline the volume of the new codes and all the places that will be affected, right down to the stores that sell scooters to the elderly. 

Wierz's presentation, "Implementing ICD-10: Lessons Learned From Canada," is scheduled for Monday, Feb. 21 at 12:15-1:15 p.m.




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