Real World Impact of ICD-10

April 21st, 2014 / By Barbara Aubry, RN

I recently read a post by Carl Natales at ICD-10 Watch that called for real world reasons to adopt ICD-10 and it got me thinking. Last Labor Day weekend (2013), I spent three wonderful days not at the beach with my family and friends, but attending an ICD-10 Boot Camp training sponsored by the American Academy of Professional Coders. I did this in order to prepare for my ICD-10 proficiency exam in order to retain my Certified Professional Coder (CPC) credential (I passed by the way). The place was jammed with coders and HIM folks, managers, and worker bees alike. We got deep into the weeds of the code set. Interestingly, there were no jokes about codes for pelican attacks or fractures as the result of impact with a park bench – as so many outside of the industry find amusing. Perhaps because most of us attending the Boot Camp have spent years having to code health care encounters without access to codes that accurately represent the patient’s injury, illness, or procedure.

My Take

As we began to review the fracture section and discussed how many of the codes for injuries and accidents had been expanded, a simple example of how ICD-10 can impact real world patient outcomes occurred to me. Consider: When you can code specifically to the cause of injury or the involvement of the patient in a given activity, the injuries with greater frequency become evident. Trends can be identified. Take bike riding for example. The cause of frequent injuries may become clear if the injuries are coded with ICD-10’s greater specificity. Recognition of the risk supports opportunities for improvement – by manufacturers of bicycle helmets, for instance. Perhaps a new design or material would provide greater safety? Or perhaps city planners could better answer common questions: What makes a bike lane safe – or not? Should it be wider?

This applies to any type of activity (work or leisure) and related equipment and environment. Ask any family member if they would prefer their loved one had access to the safest equipment possible – I think we know the answer.. I also assume manufacturers want to make the best products available – what if they had more information regarding the need? Could product development be enhanced?

This same principal applies to types of surgical procedures, approaches, anesthesia used, etc. Same with implants, pharmaceuticals, specific treatments – the list is endless.

More specific health care data is better for patients and better for business. There are many hidden opportunities for improvement and change that the data will uncover … when it is allowed to be adopted as the official code set. The sooner the better. The next time I purchase a new device I definitely won’t buy one with old data and last year’s software – would you? Why should health care be different?

Barbara Aubry is a Regulatory Analyst for 3M Health Information Systems.