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Life Health > Health Insurance > Health Insurance

Health Carriers Fear Provider ICD-10 Avoidance Syndrome

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Health insurers are feeling more confident about their ability to handle the shift to the tenth revision of the International Classification of Diseases code set, but they are nervous about doctors and hospitals.

Analysts at TriZetto Group Inc., Greenwood Village, Colo., a health care management system company, have reported that finding in a summary of results from a survey of 100 health plans and other organizations that pay for health care.

U.S. doctors, hospitals and payers now use the U.S. version of the ICD-9 diagnostic code set, which was published by the World Health Organization (WHO) in 1977.

The U.S. Department of Health and Human Services (HHS) is trying to get the U.S. health care system to migrate to ICD-10 – a code set released by WHO in 1992 and adapted by HHS for U.S. use in 2008 – by October 2013.

About 93% of payers now say they have come up with plan for migrating core administration systems to ICD-10, up from 75% in the third quarter of 2009, the TriZetto analysts report.

But the percentage of payers who say they are worried about whether health providers will be able to make the switch smoothly has increased to 32%, from 15% in 2009.

The percentage of payers that say provider problems may be the biggest barrier to the ICD-10 migration has increased to 86%, from 18%.

Meanwhile, only 9% of payers are helping providers to shift to the ICD-10 standard and testing the data coming out of migrated provider systems, the analysts say.

- Allison Bell

Other ICD shift coverage from National Underwriter Life & Health:


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