You don’t have to spend much time with me before you hear me mumble and grumble about certain subjects, one of my favorite being the (lack of) speed at which the AAP moves and how conservative it often is when protecting the needs of its members. Imagine my pleasant surprise when I learned about their official position on the ICD-10 code release scheduled for 2011. First, let’s witness the latest salvo against ICD-10, this from Congress’ Committee on Small Business – here’s their PDF. Doom, gloom, we need at least 5 years to do this. *5 years?!*
Now, take in the AAP’s position on the matter, issued a few weeks ago. “We support the rapid conversion to ICD-10-CM realizing its value to physicians and their patients. The Canadian experience and the independent evaluation of the RAND Corporation has shown that the cost of implementation will not be anywhere close to the price tag being quoted by a few trying to delay the inevitable change.” I encourage you to read the piece and see their other supporting comments.
Now, I don’t mean to suggest that the ICD-10 is a panacea. Nor will it be cheap or easy to switch. And there’s no question the insurance companies will have a blast with it. But this not only has “metric system” written all over it, I often and already feel the effects of our existing poor coding system in my work. Because of the inconsistent and vague use of the ICD-9 and CPT, there are all kinds of things that PCC and I simply cannot do that would be – pun intended – child’s play with a proper system. I was telling Greg at OP today that I’d read once that Nursemaid’s elbow is most prevalent in girls (who are often lighter, and easier to pick up) and in their left arm (most parents are right handed). Is this true – I dunno. But if we had ICD-10, I could tap a few buttons and tell you. Or about 1001 other potential patterns and relationships that we don’t already know. How can we possibly do Chronic Disease Management without, to quote the, AAP, the ability to “to track a patient’s asthma severity based on the National Heart, Lung, and Blood Institute guidelines”?
And imagine the bonus when it comes to sharing electronic data. For all the cost that it will take to move to ICD-10, why are folks not seeing the cost to not moving? The ICD-9 (and, frankly, CPT) system is a perfect example of the inefficiency which drives our healthcare system to be, what, 10%-15% of or GDP already?
When I wrote about this subject a few weeks ago, I was aware that I was taking an unpopular stance. I have no grand illusions that my position will have any affect on anything or that I’ll be able to point to my blog two years hence and say, “See! I told you!” But, for once, I am delighted and even proud of the position of the AAP on this matter.
The bottom line: ICD-10 is a big improvement over ICD-9 and is simply the right thing to do. Why not embrace it, get the pain over with sooner? Like piano or swimming lessons, your parents were right when they said, “You’ll thank me later.”