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Converting ICD-9 to ICD-10.

James H Stephens1, Gerald R Ledlow2, Thomas V Fockler3

  • 1a College of Public Health , Georgia Southern University , Statesboro , Georgia , USA.

Hospital Topics
|March 17, 2016
PubMed
Summary
This summary is machine-generated.

The United States finally transitioned from the International Classification of Diseases, Ninth Revision (ICD-9) to the International Classification of Diseases, Tenth Revision (ICD-10) in 2015. This complex conversion faced delays due to various healthcare system factors.

Keywords:
Electronic Health RecordICD-10federal mandateshealthcare providersmeaningful use

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Area of Science:

  • Health Informatics
  • Healthcare Administration
  • Medical Coding Systems

Background:

  • The United States lagged behind other nations in adopting the International Classification of Diseases, Tenth Revision (ICD-10), continuing to use the International Classification of Diseases, Ninth Revision (ICD-9) until October 1, 2015.
  • The U.S. healthcare landscape, characterized by numerous providers, payers, and diverse software platforms, presented unique challenges for a standardized system conversion.
  • Unlike many countries with single-payer systems, the U.S. faced a more complex and costly implementation due to its fragmented healthcare infrastructure.

Purpose of the Study:

  • To examine the rationale and contributing factors behind the delayed implementation of the ICD-10 code set in the United States.
  • To analyze the complexities and capital-intensive nature of the ICD-9 to ICD-10 conversion within the U.S. healthcare system.
  • To evaluate the impact of implementation delays and consider whether a further postponement would have been beneficial.

Main Methods:

  • Review of the historical context and reasons for the prolonged use of ICD-9 in the U.S.
  • Analysis of factors contributing to the delays in ICD-10 adoption, including electronic health record meaningful use requirements and vendor upgrades.
  • Examination of the healthcare system's readiness and the financial implications of the conversion.

Main Results:

  • The conversion to ICD-10 was a significant undertaking for the U.S. healthcare system, differing greatly from implementations in countries with single-payer systems.
  • Multiple factors, including concurrent technology mandates and vendor-related issues, complicated the transition and increased costs.
  • The study critically assesses the decision-making process regarding the conversion timeline.

Conclusions:

  • The transition to ICD-10 in the U.S. was a complex, capital-intensive process influenced by a fragmented healthcare system and competing technological demands.
  • Understanding the reasons for delays is crucial for future system implementations in healthcare.
  • The effectiveness of the final implementation date and the potential benefits of further delays warrant consideration.