Mandated, costly disease-coding system on hold, for now

05/03/2014 5:19 PM

08/08/2014 10:24 AM

Have you been crushed by an alligator? Sucked into a jet engine? Had your lips stuck to a musical instrument?

There’s a code for that.

Those are just a few examples of the new International Classification of Disease coding system – called ICD-10 – that U.S. doctors were preparing to transition to in October.

But the federal government recently announced that the implementation of the new system will be delayed at least another year – after doctors’ offices and hospitals across the country already paid thousands for new software.

For Central Plains Eye MDs, 7717 E. 29th St. North, the cost of training and software for ICD-10 was between $200,000 and $250,000, said practice manager John Pedersen.

That’s money for which the office will not be reimbursed by the federal government, said retinal surgeon C. Joseph Beck, principal owner of Central Plains Eye MDs.

“This is just generating gross inefficiency with no upside to doctors or patients. Show me the upside,” Beck said. “And it’s a physician-funded federal experiment.”

Questioning its value

Whenever a patient goes to a health care provider, the provider must enter codes into the patient record and submit those codes to insurance companies to receive payment for services.

The old system, which has been in use in the U.S. since 1979, includes more than 17,000 codes for procedures and diagnoses. The new system will include more than 141,700 codes, according to the Centers for Disease Control and Prevention.

“The pure number of new codes is almost mind-boggling,” said Joe Davison, family practitioner at West Wichita Family Physicians, who has worked on implementing city and statewide electronic health record exchanges.

Last year, Kevin Hoppock, family practice physician at Via Christi Clinic, past president of the Kansas Medical Society and the group’s current legislative committee chairman, met with federal officials about stopping ICD-10.

“I don’t mind incurring additional costs if it brings greater value to the patient,” Hoppock said. “This is a rare situation that provides almost zero patient value. It doesn’t help in treating patients or getting them better care.”

“The cost on the small docs is great, but it is no less of a burden on the folks who have a large number of physicians. The zeros just get bigger.”

Big and better data

The government says the new system will allow for more advanced surveillance of diseases and epidemics as well as developing a better understanding of public health issues.

“They are going to make beautiful pie charts,” Beck said.

The data could also be used to identify outbreaks faster or potentially track what medical interventions lead to the best patient outcomes, health officials say.

Physicians say the burden of collecting all of the data and paying for the system is on them, which will take time away from treating patients.

“Everybody gets to use the data. But somebody, somewhere has to create the data,” Pedersen said.

Until the federal government releases an official start date for ICD-10, many doctors will continue to fight it.

“We don’t need it delayed or simplified,” Hoppock said. “We need it dead.

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