HHS Proposes Adoption of ICD-10 Code Sets and Updated Electronic Transaction Standards

After more than a decade of waiting, the process to adopt and implement a replacement for the 30-year-old ICD-9-CM code set moved significantly ahead with the publication on Friday, August 15, 2008, of a notice of proposed rule making (NPRM) by the Department of Health and Human Services (HHS). "We are excited to see that HHS has taken this significant step forward," noted AHIMA CEO Linda Kloss, "but now we must see a positive response to the NPRM so that final rules can quickly be issued and the healthcare industry can finally get implementation started."

The announcement issued by the Centers for Medicare and Medicaid (CMS) indicates that display copies of the anticipated NPRMs have been filed. The official NPRMs—one related to adoption of the ICD-10-CM and ICD-10-PCS classifications and the second related to upgrades of the HIPAA claims-related transactions—will be published in the Federal Register, on Friday, August 22, 2008, and additional information will soon be available on the CMS web pages.

The CMS announcement includes a HHS date for compliance for the two sets of changes—October 1, 2011. Comments on the proposed rules are due no later that October 21, 2008. Both regulations can be viewed here.

To assist the industry and the HIM profession, AHIMA has announced a free 90-minute Webinar for the industry on the NPRM on Tuesday, August 26, 2008, at 1 p.m. ET, 12 Noon CT, 11 a.m. MT, and 10 a.m. PT. AHIMA staff will also publish an analysis of the proposed rule. Please visit this link for more details.

ICD - 10: Essential Component of the 21st Century Healthcare System

Information management is one of the most important methods to improve the quality of health data and patient care processes. ICD-9-CM is obsolete and is unable to meet current healthcare data needs or support the transition to an interoperable health data exchange in the US. Developed 30 years ago, it cannot accurately describe the diagnoses and inpatient procedures of care delivered in the 21st century. ICD-10-CM and ICD-10-PCS must be adopted as soon as possible to reverse the trend of deteriorating health data and to allow the healthcare industry to prepare for a smooth transition to modern classification systems before the end of this decade.

While the US is working hard to adopt health information technology, it must also accommodate a robust 21st century classification system. Adoption of national electronic health records (EHRs) and interoperable information networks require modern classification systems for summarizing and reporting data. Major health initiatives that rely on complete and accurate data are compromised by the continued use of ICD-9-CM. These initiatives include quality measurement, pay-for-performance, medical error reduction, public health reporting, biosurveillance, actuarial premium setting, cost analysis, and service reimbursement.

ICD-9-CM should have been replaced 10 years ago. Each year that passes results in further deterioration of this classification system and the data it produces. Further delays in adoption of ICD-10-CM and ICD-10-PCS also increase the cost of an eventual implementation once ICD-9-CM completely breaks down.

Read AHIMA's Position Statement on ICD-10.

See the ICD-10 Legislative Proposals section for up-to-date information on the status of federal legislation concerning the adoption of ICD-10.

Leading healthcare associations urge Congress to update health coding system. Read the joint statement on ICD-10 here.

Founded in 1928 to improve the quality of medical records, AHIMA is a not-for-profit (501c6) professional association committed to advancing the HIM profession in an increasingly electronic and global environment through leadership in advocacy, education, certification, and lifelong learning. AHIMA offers fee-based education materials and training programs to its 51,000 members and the healthcare industry on a broad spectrum of HIM topics including ICD-10. Revenue from these products allow AHIMA to continue its mission to advance quality healthcare through quality information.

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