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ICD-10: The good, the bad, and the advice

May 15, 2014
by Behavioral Healthcare editors
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Now that it has been confirmed that the transition to ICD-10 will be delayed another year, there are mixed reactions. While some providers are deeply relieved, other organizations are worried about how the delay will affect their financials.

The Washington, D.C.-based American Health Information Management Association (AHIMA) estimates that another one-year delay of ICD-10 would likely cost the industry an additional $1 billion to $6.6 billion on top of the already incurred costs from the previous one-year delay, according to Healthcare Informatics

However, the delay is not perceived as negative by everyone. A recent report from the New York City-based global rating agency Fitch Ratings is viewed as a positive credit development for not-for-profit hospitals. Adding to the turmoil are conflicting reports on how ready payers were for the transition; some say the large payers were ready, others say that a significant amount of all payers were not.

In an April 1 blog, Lisette Wright advised Behavioral Healthcare readers of the delay proposal that blind-sided most of those following the House bill H.R. 4302, the Medicare Sustainable Growth Rate Bill. She acknowledges both positive and negative consequences, most of which have yet to be determined and notes, “The US is the last industrialized country to adopt ICD-10. ICD-11 is tentatively scheduled to be released in 2017, just two years after the 2015 U.S. ICD-10 deadline.”

Behavioral health organizations have been slow to acknowledge the need to implement ICD-10. “Much work is to be done and for behavioral health organizations who still do not think ICD-10 applies to them, consider this a reprieve and an opportunity,” Wright advises.

Wright cautions that ICD-10, as well as the DSM-5 updates, will require a huge shift in organizational cultures, compliance, and willingness.  “I strongly recommend that you begin your DSM-5/ICD-10 transition process now,” she adds. “The scope of this is very large, especially testing systems and the clinical training components. Training clinicians in the dual manuals, the intricacies of the manuals, and to practice dual coding with continuous utilization review will be imperative to maintaining a strong fiscal foundation for your organization when ICD-10 goes into effect.

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