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ICD-10: The Mark Of The Beast?

November 10, 2008
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Of course not. We all know that theNational Patient Identifier is the mark of the Beast.
ICD-10 is just a pain in the butt. I read an interesting
blog posting by Richard Elmore recently. He provided an example of how trying to replicate a common, super-bill-friendly ICD-9 code for an insect bite- 919.4- could balloon to 87 different possibilities if one were to take full advantage of ICD-10's specificity. Of course, one of the things an analysis like that glosses over is that reporting a 919.4 is a pretty inadequate utilization of what was available even in ICD-9. Even there, you could get up to 20 or so code possibilities, depending on whether you wanted to specify the site of the injury and the presence or absence of infection. Truth is, we've all known that ICD-9 was inadequate for providing good clinical specificity for a long time. That's why ALL modern EMR products have to include some form of standard clinical nomenclature in order to provide meaningful ways of documenting and reporting patient's conditions. My hope is that the developers of those nomenclatures have used ICD-10 as one of the inputs into the decisions they've been making as they've worked on their products. In light of the fact that the ICD-10 standard was adopted in
1990, it should come as no shock that we would need to be cross-mapping to it. So, is adopting ICD-10 going to require some concerted effort? Sure. Is it Y2K, and HIPAA all over again? Only if you're a consultant selling ICD-10 services. Would I be that sanguine if our organization were still depending on paper super-bills? Probably not. Perhaps the important point is that all that soap-boxing for the last twenty years about REALLY needing to get our systems automated was not just for effect. For anyone who's not already working on getting your clinical and financial systems ready for this century, let me just say- Tick, Tick, Tick...

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