Mostashari: No more ICD-10 extensions

Farzad Mostashari, MDFarzad Mostashari, MD

ICD-10 isn’t about getting paid; it’s about healthcare transformation

Farzad Mostashari, MD, the national coordinator for healthcare IT, asserted today there would be no extension of the deadline for switching from the ICD-9 medical coding system to ICD-10. The deadline for conversion would remain Oct. 1, 2014, Mostashari said in a keynote delivered this morning at the HIMSS Media ICD-10 Forum in National Harbor, Md.

“There are no plans for any more extensions,” he told attendees, repeating it twice, for emphasis.

The current extension, from Oct. 1, 2013 to Oct. 1, 2014 was partly due to looking at the incremental changes needed in reforming healthcare, and realizing that “sometimes, extensions are needed," Mostashari said. It was also to allow for a crosswalk to be made between (Systematized Nomenclature Of Medicine Clinical Terms) SNOMED, a more physician friendly systematically organized computer-processable collection of medical terms used for diagnoses, and ICD-10.

[See also: House panel grills Mostashari on delay of widespread interoperability.]

During the past year, the Office of the National Coordinator for Health IT commissioned the National Library of Medicine to do a detailed crosswalk between SNOMED and ICD-10, in an effort to help ease the transition to ICD-10, Mostashari said, adding that he believes the meaningful use program and the conversion to ICD-10 “can be synergistic.”

Physicians are going to be better able to “document care” in SNOMED, because it’s “constructed the way physicians think,” Mostashari said. It will help physicians find the right code and enable the physician to share only what is needed with the physician or hospital’s billing department. In this sense, SNOMED and ICD-10 will be able to ensure the patient has more privacy, by limiting the amount of clinical notes that are shared with the billing department.

Mostashari expressed faith in the American free market to make the ICD-10 conversion easier: “There’s a lot of money to be made in helping doctors get ready for ICD-10,” he said.

At the same time, he recognized some “market failure,” so far, with the selling and purchasing of electronic health records on the basis of functionality alone. Three months after purchasing EHRs, physicians often don’t understand what they have purchased; and the price of switching EHR vendors is currently too high, said Mostashari.

[See also: Mostashari, policy committee take critical look at CommonWell.]

“At the end of the day, this massive transformation (of healthcare reform) isn’t going to be about ICD-10,” he said. It’s going to be about paying for higher quality healthcare, in addition to improved population health, more patient engagement and better transitions of care.

Mostashari said the government wants to be partners with the industry in “that journey, that battle,” going forward.

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