Go beyond code crosswalks; take full advantage of the ICD-10 transition

By Jill Gardner on June 22nd, 2010

Lots of folks talk about mapping ICD-9 codes to ICD-10 codes and vice versa. That’s a very important, very practical need. After all, once the 250.xx series goes away, for example, clinicians must know how to code for their diabetic patients.  But focus too intently on code crosswalks and you could be missing the forest for the trees. I’d suggest that everyone look beyond just the code update; ICD-10 presents a unique opportunity to identify ways to improve so many aspects of medicine—both clinically and financially. Healthcare organizations should be encouraged to take that “next step”: don’t merely identify the places where ICD-10 codes must be substituted for ICD-9 codes; identify the ways ICD-10 can do a better job than ICD-9.I can hear the groans already. “What an ivory tower idea! Do you have any idea how much work it will take simply to switch the codes, let alone look at ‘process improvement’ at the same time?”

Absolutely. So why not get more out of all the effort than just a “code swap”? I saw a blog recently that included this idea on a list of five “best practices” for the 5010 and ICD-10 conversions. On that list were:

  • Develop an enterprise-wide assessment to understand full organization impact
  • Use the assessment to identify opportunities for innovation and process improvement

I know there’s already so much work to be done that the prospect of converting to ICD-10 can seem overwhelming to many. But it’s also very clear that, on the whole, medicine in this country is moving toward evidence-based protocols and quality measurement. That’s where ICD-10, with its advanced degree of specificity, can play a crucial role.In fact, the Centers for Medicare and Medicaid Services (CMS) has published a “Quick Reference Information” sheet that discusses the benefits of ICD-10-CM. The very first of 11 bullets states, “Measuring the quality, safety, and efficacy of care.”  Other bullets talk about payment system enhancements, performance monitoring, and more.The entire healthcare community already is looking to see where ICD-9 codes must be replaced. Sooner or later, it also will need the ability to measure and report on all sorts of clinical and business indicators. ICD-10 can aid in those efforts. Why not conduct both assessments at once, comprehensively?A lot of work now, yes. But while there’s still time, it’s worth beating the drum. In the long run, killing two birds with one stone may prove to be the most efficient, productive, and profitable use of resources.