The Centers for Medicare and Medicaid Services (“CMS”) and the Centers for Disease Control and Prevention (“CDC”) announced the 2017 ICD-10 coding update to be implemented October 1, 2016 and it’s a doozy. The first annual update since the partial code freeze was enacted in 2011 includes the addition of 3,651 ICD-10 hospital inpatient procedure codes and 1,900 ICD-10 diagnosis codes (a whopping 5,500 code increase).
The announcement doesn’t come as a surprise to many, but the sheer volume of change is still overwhelming. As HighPoint predicted years ago, the operational implications of the breadth and depth of ICD-10 are as daunting as transition. Healthcare organizations need to be prepared for managing voluminous annual code set/mappings updates on a rolling basis.
In 2012, I wrote about the notion of Enterprise Codeset Repositories and their importance in managing ICD-10’s operational complexity. The recently announced codeset update validates that once the code freeze expired, there would be significant annual change in codesets. We believe that our other assumption—that operational processes will likely fail in trying to handle large volume annual updates for ICD-10—is likely to occur this summer/fall.
We suspect that many organizations’ codeset management processes and tools will be inadequate to handle 5,500+ changes in a single annual update. Some of the hindrances we’re anticipating include processes and tools being too slow, too manual, and too “code at a time”. If you are worried about any of these issues, or haven’t considered a back-up plan, you should start your research now.
If you’re concerned that your current codeset management won’t handle the annual updates efficiently, we should talk. Our Enterprise Codeset Repository solution was built to handle scale and is deployed within several payers and providers. For more information, contact Jeffrey.DiBartolomeo@highpointsolutions.com.