ICD-10 go-live: Nightmare or non-event?

The closer we get the more it appears the compliance deadline will pass much like Y2K and HIPAA 5010 before it
By Tom Sullivan
08:08 AM
Scared woman

The ultimate irony of a long standing ICD-10 to Y2K comparison is that – after all the years of debate, disdain and doomsday predictions – it now appears that the go-live will likely pass after the same fashion that Y2K did: imperfectly but more or less quietly.

What I'm referring to is the actual compliance deadline, October 1, 2015 of course, as well as the days and weeks immediately following, rather than the drawn-out conversion during which providers will learn to code and submit claims in ICD-10 and insurers will accept, process and pay those.

None of this is to say that there won't be problems in the near term but they are not going to be nearly as apocalyptic as so many have prophesized.

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There will be glitches
To address this upfront: Problems will arise, claims will be denied, clinicians will grow impatient with the new classification system and a dip in coder productivity is inevitable.

Worse, some small providers will really struggle as their cash flow is disrupted and a subset of those may even shut down, be gobbled up or otherwise align with organizations more prepared for ICD-10 – or they'll simply open lines of credit to keep their business operational until this gets straightened out. 

Don't get me wrong: I don't think the industry is nearly as prepared as it should be. Healthcare IT News, rather, has reported survey after survey bearing that out.

But it doesn't mean we're in for a total disaster here either.  

While it would be a stretch to call ICD-10 déjà vu there are two existing points of comparative precedent: Y2K and HIPAA 5010.

Pointing to predecessors
During the months, weeks, then days leading up to Y2K, fearful predictions were rampant. Power outages striking homes, banks and food markets would lead to looting and rioting in streets full of freezing people. Nuclear meltdown? Well, perhaps in hindsight that was not actually a legitimate concern but it did get bandied about nonetheless.

That fear was ingrained into the American conscious enough that my father-in-law, and no I am not making this up, dispensed supplies for Christmas of 1999, including batteries, cash, flashlights, water, canned food and, to one of his daughters, a portable toilet.

HIPAA 5010, only pertinent to the healthcare industry, was admittedly different, smaller, and with considerably less at stake. But that didn't stop healthcare professionals from predicting a trainwreck of denied claims and the potential for smaller medical groups to collapse on account of disrupted cash flow.

In the cases of both HIPAA 5010 and Y2K, in fact, glitches emerged. Claims got confusing and reimbursement was, in certain instances, delayed in the wake of HIPAA 5010 but those problems were worked out in reasonably short order.

History has already let 5010 slip from memory and as for Y2K well, it has since been called the disaster that never happened, a collectively imagined threat, as well as a quiver of conspiracy theories suggesting the whole thing was a scam born of FUD, as in fear, uncertainty and doubt.

And as the Oct. 1, 2105 deadline draws closer the possibility that the actual ICD-10 turnover will follow suit becomes more and more distinct. The sun will rise come October 2, Nov 31, and even January of 2016, hospitals will do what it takes to get paid under the new coding system, and life will indeed continue.

Of course, I could be proven wrong in the next few days. What's your prediction? Will ICD-10 go live be a nightmare or a non-event? 

Related articles: 

Innovation Pulse: Pick your own ICD-10 adventure

The case for creating an ICD-10 command center

ICD-10 readiness in a state of 'shaky optimism'

Industry eyes calendar with ICD-10 countdown underway 


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