Is ICD-10 really needed in the US?

Key industry players, such as the AMA and MGMA, have questioned whether we really need ICD-10-CM in this country.  They seem to think there will be no benefit to clinicians with the upcoming change in the diagnosis coding system.  I think they’re wrong.  The current system hasn’t been overhauled since 1979.  It’s been updated every year but it can’t move forward to work in the electronic environment and it can’t capture information about current day medical practice.  It’s pretty hard to describe cutting edge medicine with a 34 year old system. 

It’s like driving a car that wasn’t built to be environmentally-friendly or get 55 miles to the gallon.  No amount of upgrades to the old car, including changing out the engine, will make a car from 1979 into an environmentally-friendly, hybrid car that gets great gas mileage.  The car has to be designed and built that way.  ICD-9-CM just wasn’t built to handle the terminology and technology of today’s health care system.

I’d say there’s an immediate benefit to clinicians on 10-1-2014 when they are able to support the services they provide with better diagnosis codes, describing the disease in modern terms.  The new ICD-10-CM codes show the severity of the patient’s condition and can better support Evaluation and Management code levels, as well as the surgical procedures that the patient might need. 

Take asthma, for example.  In the current system, we can code either intrinsic or extrinsic asthma. We can also code that the patient is having an acute exacerbation today or is in status asthmaticus today.  But, we can’t describe the day-to-day severity of the patient’s symptoms. ICD-10-CM uses newer terminology that describes intermittent or persistent asthma and the degree of mild, moderate or severe. Each of those degrees can be described with acute exacerbation or status asthmaticus.  In the office setting, it shows the difference between a patient with severe persistent asthma and one with mild, intermittent asthma. In a surgical setting, the new codes do a better job of describing that a patient with severe, persistent asthma is a good candidate for a procedure called bronchial thermoplasty to help treat their symptoms.  The codes describe that the patient is sicker and could benefit from the surgery. That’s just one example in the new system and there are other great benefits to clinicians to be found there.

The clinicians of the future will also benefit because the health care advances of tomorrow are built on today’s data. Today’s data goes to the CDC for analysis of public health concerns as well as to pharmaceutical companies and device researchers who are designing and testing the products of the future.  That new, more detailed asthma information can help researchers figure out what the best medications and treatments are for patients with different degrees of asthma, as well as asthma in combination with other conditions, such as hypertension or diabetes.  This new data may help researchers connect the dots between diseases that we never knew were related. Yes, there are benefits and we need a new system.

Blog submission by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA