ICD-10 transition proving complex, expensive for hospitals

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The transition to the ICD-10 diagnostic code set will be expensive and difficult, industry observers agree in a recent Computerworld article. The average hospital will spend between $2 million and $5 million to upgrade and/or replace its systems, and ICD-10 will cost large healthcare organizations upward of $20 million.

The healthcare industry celebrated two years ago when the Department of Health and Human Services postponed the deadline for using ICD-10 codes on all claims to Oct. 1, 2013, from the prior date of Oct. 1, 2011. But now, even as hospitals face a deadline that's only a little more than two years away, a majority are still in the early stages of switching over to ICD-10, according to the American Hospital Association.

In a 2010 report, Christine Armstrong of Deloitte Consulting pointed out that the current ICD-9 codes are "deeply imbedded as part of the coding, reporting, research and reimbursement analysis conducted today." So hospital financial and clinical systems of every kind will have to be upgraded to accommodate ICD-10. In addition, interfaces among a hospital's various systems will have to be changed.

Robert Alger, vice president of health plan IT strategy at Kaiser Permanente, said the preparations for ICD-10 are more complex than the Y2K effort at the turn of the century. Kaiser began its ICD-10 implementation effort in 2009 and expects to complete it next year.

Aside from staff retraining, which can take two years or more, physicians must also relearn documentation so that it can justify the more granular diagnostic codes. The ICD-10 set contains 68,000 codes, compared to 15,000 ICD-9 codes. 

To learn more:
- read the Computerworld article
- see the Deloitte report 

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