Is ICD-10 the Next y2k?

I’ve started to see more and more people comparing ICD-10 to y2k. I think it’s going to be a great comparison for most organizations. Given the lead time for ICD-10, I believe that ICD-10 is going to be a non-event for most of them. Sure, there will be some hiccups along the way, but nothing major to report.

What’s certain to me is that October 1, 2015 will be a total non-event. I know hospitals are already planning their ICD-10 go live parties, but I don’t think there’s going to be much to talk about. Any problems or issues they have with ICD-10 probably won’t be apparent right away. I think that any major issues with ICD-10 won’t come to light until months after ICD-10 is implemented.

Wait for the stories to come out 2-3 months after ICD-10 is implemented. Then, we’ll start hearing about insurance companies that weren’t ready to process ICD-10 claims or had issues with the way they were processing it. Months later we’ll hear about healthcare organizations that aren’t getting paid and are facing cash flow issues. ICD-10’s impact isn’t going to be over on day one like it was for y2k. It’s a very different issue in that regard.

The other reason I don’t think we’ll hear much about ICD-10 issues is that healthcare organizations that run into issues aren’t going to broadcast that fact. Are we really going to hear healthcare organizations chiming in that they botched their ICD-10 implementation, thought it was going to be delayed again, and weren’t ready? I don’t think so. Any problems with ICD-10 are going to be kept private. At least until an organization isn’t getting paid and goes out of business.

I’m sure we’ll have a wave of ICD-10 implementation articles hit on October 1, 2015. My guess is that none of them will be worth reading since there won’t be anything to say. Wait until Thanksgiving and we’ll start to see the real stories about the challenges of the ICD-10 implementation start to hit the wires.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

4 Comments

  • In my opinion, the only way the ICD-10 cutover compares to Y2K is that it’s like to be a non-event – just as John states. Otherwise, ICD-10 is NOTHING like Y2K. There are three main reasons why:

    1. Y2K had a fixed date. It was not going to move unless an Act of God occurred. Literally, God would had to act in a pretty major way. Like make time stand still or flood the earth prior to 1/1/2000.

    2. ICD-10 impacted a lot more than just software. Documentation, workflow and processes were also impacted and needed to be remediated.

    3. Y2K didn’t bring about any new functionality or benefits. It was basically an exercise in maintaining equilibrium. Nothing was gained from Y2K – except maybe some technical debt that was retired while remediating date logic in software. Whereas, ICD-10 is really all about improving the ability to identify and capture diagnoses information.

  • I agree with Steve.

    Y2K was a bust – all it took was to remediate the systems. The “Y2k part” of ICD-10 is easy too, It is the re-development of clinical workflows from soup to nuts to ensure that physicians are documenting well enough to assign ICD-10 codes. This is not hard, but it requires preparation, thought and real work to update workflows. The majority of hospitals will be ok, though not perfect and the lesser prepared will see disruption of workflow. The totally unprepared hospitals, those that did not get started until the last couple months, will die and have to be rescued by local acquirers. I think physician practices will fare much worse because they are generally less prepared, BUT they are also smaller so they can be rescued (by high price consultants maybe?) easier. BUT ALSO Physicians in their Practices have not really been documenting like they should for ICD-9, they have been more “assigning codes” so a mindset change is required. I believed from when I started ICD-10 consulting in 2009 that 5-10% of providers would not survive it and I think that is probably still true, if not an underestimate.

  • My guess its going to be a big challenge and much more disruptive and complex that anyone can imagine. That there are unforeseen hitches that could have been worked out with a soft transition from 9 to 10, or overlapped period. I also think that CMS will try to minimize the damage and any failures will be pointed towards everyone else but CMS, mostly at providers. Now just a week before, our clearinghouse wants us to separate all the 9 and 10 claims into different files. AND to rename the upload from the usual .txt to .icd9 for 9 and .icd0 for 10. Yeah, a week prior. You do know what that does to workflow and efficiency? The costs of programming? It would have been much better to let us do 9 or 10 starting on Oct 1. Then we could jump in with 10 for a few claims, and see how it went. Look for bugs. Then when the time is right, maybe a year later as deadline, go all 10. I still think that this might happen. I also think that the quiet failures will become more vocal as the system breaks down. I also think that CMS will hold onto the conversion as long as they can until forced to remediate. And if they don’t, we are going to see a major efficiency disruption and significant loss of providers as they just cannot make this work. I was a willing tester for ICD-10 but could not test as they only selected a few thousand from the hundreds of thousands of providers to test. Further, I could not test directly with Medicare as I go through a clearinghouse. Finally my clearinghouse is not testing icd10 claims. Its kinda a joke really right? Everyone said test test test and I could not find anyone that would let me test. I even tried the CMS ombudsman and got very limited responses and no help, just pointing to CMS web links, in which most were broken and completely unhelpful. So I can see how this will go. My guess is…not very well.

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