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Experts predict bleak results after ICD-10 implementation date

As the Oct. 1 ICD-10 implementation date nears, a trio of experts has expressed varying degrees of doubt about the long-term success of the updated disease classification codes.

John Halamka, CIO at Beth Israel Deaconess Medical Center in Boston, thinks that "a few years from now [people] will discover that the whole idea of ICD-10 wasn't helpful to anyone," he said. And he is not alone in this less-than-optimistic sentiment when it comes to ICD-10 codes.

For example, Robert Tennant, senior policy advisor of government affairs at the Medical Group Management Association -- a professional organization in Englewood, Colo., that provides guidance for healthcare administration management and medical practice managers -- believes productivity across the board in healthcare organizations will plummet after the ICD-10 implementation date.

Meanwhile, Harsh Dhundia, director at Pace Harmon, a consulting firm with offices in Washington, D.C., San Francisco and Chicago, added that due to the resulting lower productivity, healthcare organizations will also experience a loss of revenue. Inaccurate coding will also contribute to this problem, he said. "If a doctor sees a patient … and if there isn't enough supporting documentation, you're going to be forced into a lower value code, so you get compensated lower."

One pixel VIDEO: What is ICD-10?

In addition, Tennant doesn't see the value of switching over to ICD-10, for either the patient or the physician, in the first place.

"It's very, very unclear for a lot of folks why, frankly, the industry is doing this," Tennant said. For example, "the fact that the government is not defraying any of the cost; all the costs are being borne by physician practices. So add it all up you've got a lot of skepticism regarding the value of moving to this code set."

One of the differences between ICD-9 and ICD-10 is the thousands of added codes in the newer version, something that Halamka does not think will improve claims auditing.

"The number of codes we used in ICD-9 will equate to the number of codes we use in ICD-10, and there will not be improved granularity or reduction in fraud and abuse," he said. "[I] don't want to be a pessimist, it's just ICD-10 was never designed to be a billing vocabulary, it's an epidemiological vocabulary. It's the wrong tool for the wrong purpose."

Let us know what you think about the story and the ICD-10 implementation date; email Kristen Lee, news writer, or find her on Twitter @Kristen_Lee_34.

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