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AHIMA takes aim at ICD-10 delay

A top AHIMA official unleashes a broadside in correcting what she sees as pernicious stories about ICD-10 and argues for swift implementation.

A top official of the American Health Information Management Association has published an attack against what she calls "myths" and "misinformation" about the one year ICD-10 delay.

Sue Bowman, American Health Information Management Association's (AHIMA) senior director for coding and compliance, argues in "Myths of ICD-10-CM/PCS", in the August issue of the Journal of AHIMA, that "replacing ICD-9-CM is not optional."

"ICD-9-CM is obsolete and no longer reflects current clinical knowledge, contemporary medical terminology, or the modern practice of medicine," Bowman writes. "Its limited structural design lacks the flexibility to keep pace with changes in medical practice and technology. The longer ICD-9-CM is in use, the more the quality of healthcare data will decline, leading to faulty decisions based on inaccurate or imprecise data."

The article comes four months after Congress passed and President Obama signed a one-year delay in the rollout of the updated medical coding standard. Some doctors' groups, including the Medical Group Management Association, lobbied for the delay on the grounds that putting ICD-10 into effect this year was proving expensive and time-consuming. AHIMA is perhaps the most outspoken health IT group advocating for a quick transition to ICD-10, and the most active in opposing further delays that some in the industry have been calling for.

In an interview with SearchHealthIT, Bowman said she was moved to write to counter lingering anti-ICD-10 sentiment that she thinks has not been sufficiently countered.

"There's been a lot of persistent myths and misinformation around this and I thought I'd be able to correct some of these myths," she said. "There are two things I'm hoping to do. Obviously, I don't want it to be delayed any longer, and I'm hoping to combat some of the scare tactics and reassure some of the providers."

In the piece, Bowman takes aim at what she sees as the main myths circulating about ICD-10: that replacing ICD-9 is not a necessity; that the increase in the number of codes from ICD-9 to ICD-10 makes it harder to use the new code set; and that ICD-11 or SNOMED CT, another coding standard, are viable alternatives to ICD-10.

Bowman argues that ICD-9 codes are often vague and healthcare providers "often don't know precisely what was wrong with patients or what treatments they received."

She also makes the case that ICD-10's much larger compendium of codes will make code reporting more accurate, efficient and easier -- rather than more difficult and complex as some critics have suggested.

Comprehensive dictionary

"In fact, the correct code is easier to find in a more comprehensive and detailed code set -- just as it is easier to find a word in a comprehensive dictionary," she writes in the journal. "Coding is easier when detailed and precise codes are available."

Also, Bowman notes that 46% of the added codes in ICD-10 simply provide the ability to identify the affected side of the body, right or left, and do not pile on difficult complexity but rather supply more accuracy.

Finally, Bowman maintains that SNOMED CT and ICD-10 are designed for different purposes. ICD-10's focus is statistical, while SNOMED CT is clinically based. As for ICD-11, waiting for that coding set would take far too long given the nearly 20 years it has taken to establish ICD-10, she argues.

Meanwhile, Bowman warned in the interview that U.S. healthcare is languishing under an outdated coding system that is harming the quality of care and driving up costs, principally by wasting training and forcing some providers to maintain dual coding systems.

"Every day is costing more money," she said. "The harm to patient care is we keep on delaying the arrival of more and better data. As long as we are limping along with ICD-9, we're not giving better healthcare to patients."

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