June 1st, 2014

ICD-10 conversion delayed

In a surprising turn of events, after the Centers for Medicare and Medicaid Services had sworn there would be no extension to the deadline for the conversion to the ICD-10 diagnostic and procedural codes, the U.S. Congress recently passed a bill that included a one-year extension to the launch.

In March, the legislature passed a hotly debated bill designed to temporarily address the problem of Medicare cuts for physicians. The ICD-10 delay was added as a one line side item.

The ICD-10 is the latest edition of the International Classification of Diseases, a coding system created by the World Health Organization and used in nearly all of the 193 WHO member countries except the U.S.

Since health care in this country is so much more complex than in other parts of the world, changing to the new codes has been more difficult. The U.S. currently uses ICD-9 codes, although many psychologists may not realize this fact because the codes are virtually the same as the codes used in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.

All health care providers and other entities, covered by the Health Insurance Portability and Accountability Act (HIPPAA) will be required to convert to the updated codes.

The delay for the ICD-10 change-over was unexpected and, for some providers, causes more problems than it solves because they had been working towards compliance this October. Industry groups have been pushing on both sides of the issue for and against a delay. Some have suggested waiting for the eleventh version, although that is unlikely because that is not due to come out until 2017 and would still need U.S. modifications.

The concern is that providers may not be ready for the new codes which could cause major disruptions if the deadline remained for this October.

“Whether you see a positive or negative impact of the delay depends upon how you look at it,” says Traci Cipriano, JD, Ph.D., director of professional affairs for the Connecticut Psychological Association. “On one level, the delay in implementation gives psychologists a bit of a respite during this time of great change in psychology practice. On the other hand, when the rest of the world has been using the ICD-10 for years, it might appear that our practitioners are a bit behind the times. For those who are not ready, including myself, it makes sense to start getting comfortable with the ICD now, so there is not a panic come Oct. 1, 2015.”

With this newer version, codes are alpha-numeric, rather than simply numeric and there are far more codes, 68,000 compared to the last version’s 13,000.

The good news, for psychologists, is that most of the changes are on the medical side rather than with mental health, says Lynn Bufka, Ph.D., assistant executive director for research and policy for the American Psychological Association.

“In terms of mental health classifications,” she says, “ICD-9 and 10 are fairly similar and the kinds of codes don’t change that dramatically.”

DSM-5, which was released in spring of 2013, references codes for both the ICD-9 and ICD-10.

“I still contend that it is not that big a deal for psychologists,” says Bufka. “In some ways it will be easier because on Oct. 1, 2015, if you are not using alpha-numeric codes, then you will know you are not using the right codes.”

By Catherine Robertson Souter

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