ICD-10 was first endorsed in 1990. Here's why it took us 25 years to implement.

Switch to new code set has been delayed three times

Josh Zeitlin, Associate Editor

Today's the day: The official transition to the ICD-10 code set.

It's been a long road to this point.

The World Health Organization (WHO) first endorsed ICD-10 in May 1990, and the first WHO member states adopted the new code set in 1994.

Canada adopted ICD-10 in 2000. Here's why their experience doesn't tell the whole story.

But as Randy Lilleston reports for Healthcare DIVE, technical and cost concerns, politics, and opposition from the American Medical Association (AMA) and other groups contributed to the United States holding off for a long time on committing to ICD-10.

Then, in 2008, the George W. Bush administration announced that the new code set would be implemented on Oct. 1, 2011.

But the AMA and other groups continued to push back against the switch, and in 2009 the Obama administration moved the start date to Oct. 1, 2013.

And in February 2012, then-HHS Secretary Kathleen Sebelius announced yet another delay, saying in a statement that the administration was reacting to providers' concerns "about the administrative burdens they face in the years ahead." The department pushed the start date to Oct. 1, 2014.

As the deadline approached, it seemed like that date might actually stick. In February 2014, just about eight months before the planned transition date, then-CMS administrator Marilyn Tavenner said, "There are no delays and the system will go live on Oct. 1."

But the AMA and other groups kept pushing back, with then-president Robert Wah declaring in a 2014 speech, "If it was a droid, ICD-10 would serve Darth Vader," adding, "For more than a decade, the AMA kept ICD-10 at bay—and we want to freeze it in carbonite."

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Congress didn't quite go that far, but it did add yet another delay in March 2014, this time passing legislation to require the start date to be pushed back by at least one year.

But then in July 2014, the seemingly impossible happened: HHS set a new transition date of Oct. 1, 2015—and it stuck. And once CMS announced a set of measures in July 2015 to ease the ICD-10 transition, AMA shifted its stance, and began partnering with the agency on implementation.

What the ICD-10 grace period means for you

Which brings us to today. While it remains to be seen how smoothly the transition goes, after more than two decades, providers have finally flipped the switch from ICD-9 to ICD-10.

"It's great to say we should've done it" sooner, the Advisory Board Company's Ed Hock said on the Weekly Briefing podcast this week. But "the delays have provided hospitals and physician practices time to hopefully get this right, so the disruption is minimal."

You have a lot to do for ICD-10. We help you do it right.

As you prepare for life after the ICD-10 transition, do you know whether your post-Oct. 1 plan will get you where you need to be? Learn how Revenue Optimization Compass gives you visibility into your performance so you can effectively protect your revenue now and after the transition.

For more information about Revenue Optimization Compass, or to request a demonstration of the technology, please contact Erika Renson at rensone@advisory.com or 202-568-7932.

Want to hear more from Ed? Join him on an Oct. 20 webconference where he'll share our latest findings on a post ICD-10 world.


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