ICD-10 and Urologic Oncology: A Disappointing Combination
ICD-10 and Urologic Oncology: A Disappointing Combination
Leonard G. Gomella, MD
Published Online: Friday, October 24, 2014
Sidney Kimmel Cancer Center Sidney Kimmel
Leonard G. Gomella, MD
Professor
Chair, Department of Urology
Director, Kimmel Cancer Center Network
Jefferson University HospitalSAP The 12-month countdown to the adoption of ICD-10 has begun. ICD-10 represents the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (usually referred to as “ICD”), now overseen by the World Health Organization (WHO). The overall goal of the ICD project is to standardize medical diagnosis and track diseases worldwide with the use of uniform codes to improve consistency among physicians and hospitals in recording patient symptoms and diagnoses.
These systems are now also used to more accurately classify reimbursement rates. Although the United States will be adopting this upgrade to ICD-9, we are actually one of the last major countries to implement the ICD-10 system.
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The Healthcare Billing and Management Association (HBMA) resurveyed industry members this month in an effort to learn more about current progress toward the anticipated implementation of ICD-10 in October 2015 and ongoing impediments to readiness. Not unexpectedly, there was good news and bad news.Perhaps most importantly, the results allow us to focus on the problem areas that could potentially threaten a smooth transition. Because HBMA members work directly with providers, practice management systems, clearinghouses, payers, and beneficiaries, our perspective offers depth and breadth on the issues.
In comparison to our previous survey, conducted in May of this year, there were some expected similarities. In both surveys more than 80 companies responded. Sizes of those companies ranged from fewer than 25 employees to more than 300 employees. Participants bill predominately for office-based physicians followed by multiple types of clients, including facilities, ASC, DME, ambulatory, etc. Seventy-nine percent of respondents bill in more than one state. Both proprietary and commercial practice management systems are relied upon by these respondents, and almost all submit claims through clearinghouses, as well as directly to payers. Coding is performed internally by coders who rely upon medical records, by clients, or is otherwise outsourced, computer-assisted, or accomplished using an electronic health record (EHR). Many companies have combinations or all of the above methodologies currently in use.
EDITOR’S NOTE: Rhonda Buckholtz is scheduled to participate in a stakeholders’ national conference call being conducted by the Centers for Medicare & Medicaid Services today on the topic, “The ICD-10 Code Set Increased –Why?” Excerpts are in the following article.
We all know that the official deadline for implementing ICD-10 has been moved to Oct. 1, 2015. Any healthcare organization that singles out that date as its primary focus, however, is placing itself at grave financial risk. While there are some portions of ICD-10 that simply cannot be implemented in production early, like sending ICD-10 codes on claims, there are others that can – and simply must – be implemented earlier.