BCBS Warns Against Hasty Adoption of ICD-10 Coding

Washington - At a hearing before the House Ways and Means Subcommittee on Health, Joseph Smith, senior vice president and chief information officer of Arkansas Blue Cross and Blue Shield, urged Congress to adopt a realistic timetable for a major shift in medical coding, moving systems from ICD-9 to ICD-10. Smith testified at the hearing, which focused on health care information technology, on behalf of the Blue Cross and Blue Shield Association (BCBSA).The bill Smith referenced, HR 4157, the Health Information Technology Promotion Act of 2005, calls for the major conversion of diagnostic and procedural codes that providers and insurers must use by 2009. Systems would change from ICD-9 diagnosis codes, which include 13,000 codes, to ICD-10, which includes over 120,000 possible codes.

"While supporting much of HR 4157, we strongly urge the committee to allow three additional years to switch to ICD-10," says Smith. "More time is critical because extensive work is required before providers and payers can implement this complete coding overhaul."

Smith argued that an additional three years is necessary to make the change responsibly, without putting provider payments and patient care at risk. He noted that hospitals, physicians and other healthcare providers will need time to acquire and learn to use the technology necessary to determine which of the 120,000 codes is appropriate. In addition, Smith's testimony cautioned against the current timetable's layering multiple simultaneous system changes; in this case coupling a conversion to ICD-10 with Medicare's planned consolidation from 50 contractors to 15. Smith stated that to avoid unnecessary risk, Medicare contractor consolidation must take place before contractors can shift to ICD-10.

Smith noted that BCBSA strongly supports the provisions in the bill calling for the creation of interoperable standards.

In addition, Smith's testimony explained the lessons learned in creating an interoperable healthcare technology model in Arkansas, and highlighted the role Blue Plans across the country are taking in advancing health information technology.

Joseph Smith's complete oral and written testimony can be found at www.bcbs.com/news/index.html.

Source: Blue Cross and Blue Shield

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