Congress should be realistic about timing when it asks the health insurers and providers to move to a new language for describing medical diagnoses and procedures.
Officials at America’s Health Insurance Plans, Washington, made that plea today during a conference call held to discuss a proposed shift to the International Classification of Diseaseas, 10th Revision, from a modified version of the ninth revision.
The U.S. health care system has been using ICD-9-CM, a coding system that offers a choice of about 24,000 codes, since the 1980s.
The World Health Organization released the 10th revision, which offers a choice of about 200,000 codes, in 1992. The United States began using the 10th revision to describe causes of death in 1999, but it is still working on using ICD-10 to report matters related to morbidity.
A bill in the U.S. House would require health insurers to complete the shift to ICD-10 by 2009.
Pushing the completion date back to 2012 would be more reasonable, AHIP President Karen Ignagni said.
Although shifting to ICD-10 will give health care providers and payers a much more detailed system for describing medical procedures and diagnoses, it also will force every entity active in health care to make major changes, AHIP officials said.
“We don’t want to stop the transition to ICD-10,” Ignagni said. But giving insurers more time “will help provide a smooth transition to the new codes by allowing for pilot testing that will help minimize unintended consequences.”
AHIP also believes that the U.S. health care system should adopt the new Health Insurance Portability and Accountability Act electronic transaction standards, ANSI X12 v.5010, before changing ICD coding, Ignagni said.
The ANSI X12 v.5010 shift would take about 2 years, and the ICD shift could take another 3 years, Ignagni said.
The standards shifts could force insurers to update their information systems, according to Kenneth Fody, a managing consultant at International Business Machines Corp., Armonk, N.Y.
“This is a total business project for payers,” Fody said.
The projects will involve provider relations as well as information technology, because providers will want to keep the ICD shift from hurting reimbursement levels, Fody said.