A few days ago, Health and Human Services secretary Kathleen Sebelius issued a press release related to delaying ICD-10 implementation from October of 2013 to October 2014. There is much controversy related to ICD-10 codes. The proponents state that ICD-10 is a more precise method of coding since there are over 65,000 codes compared to over 14,000 for ICD-9. The protesters state that 14,000 codes are more than enough codes and there will be much confusion and cost to the healthcare system by moving from 14,000 to 65,000 codes. Since the Healthcare system would like to move toward ‘bundled payments’ for services, moving to a more complex coding system does not seem in alignment with the movement to bundled payment. Delaying ICD-10 by at least a year is a good idea for Pediatric Practices as well as other areas of Medicine. I believe the leaders of Policy, like Kathleen Sebelius, see the benefit of delaying this decision as well. With the changes of additional Medicaid lives and Health Exchange lives in the next few years, there is uncertainty as to how this will impact primary care pediatrics.
Adding the burden of Pediatric offices needing to identify how they should be coding with a new ICD-10 system as well as introducing millions more lives into the Health system might have a negative impact such as a major shortage of Pediatricians to patients. How many Pediatricians want to go home after seeing 20-30 patients in a day and read about 50,000 additional codes? Do we want our primary care Pediatricians focused on these details versus how to optimally diagnose and treat patients? The good news is that currently ICD-10 is over 2 years away. Much can happen in two years that should help the decision makers evaluate if we should migrate to ICD-10 at all or decide to delay again. Most Pediatricians are losing thousands of dollars per year due to improper coding, lack of systems that track each claim as well as the wide range in abilities of Pediatric offices to manage the revenue cycle. Pediatricians do not deserve to be under paid due to these controllable issues.