It’s an easy enough parallel to draw and one likely to swirl around the AHIMA Convention and Exhibit next week. Thing is: Y2K and ICD-10 are really askew.
As far back as three years ago, one well-known ICD-10 expert who has since undertaken a similar post in one of the world’s largest IT vendor’s global services arms tried to straighten out the misperception, by then an already well-tread cliché.
“Anyone who says it will be like Y2K,” she explains, “doesn’t really understand ICD-10.”
Yet the notion persists. As recently as September mainstream sites wrote about ICD-10 as healthcare’s Y2K. It’s a safe bet that it will happen again before October’s end.
Nevermind that healthcare already hurdled the Y2K. Like every other industry — and indeed despite apocalyptic predictions — Y2K gobbled up hordes of cash, programmers, and even some nights that should have been spent in holiday cheer. And that’s where the similarities cease.
The day after
By the time the Times Square ball dropped America into the new century, earlier time zones had already made the transition safely and anyone paying attention understood that Y2K birthed no zombies, after all.
Whereas Y2K immediately began its fade toward forgettable the second the century turned over on Millenium Island, newly-rechristened for the occasion, when the ICD-10 compliance deadline comes healthcare organizations have to actually change business processes, coding practices, and substantive workflows, among other adjustments.
“When you read the data, coding could be impacted 20-40 percent for some period of time and that has a downstream impact to revenue,” says Mike Taylor, CIO of Roper St. Francis Healthcare. “So I don't think the Y2K comparison is a reality.”
What’s more, there are healthcare and insurance verticals that are not covered entities and will still operate in ICD-9, including property and casualty insurance health plans, worker’s compensation programs, disability insurance programs, state agencies, and health data repositories –meaning the whole industry will not exactly be speaking the same language.
“It’s going to be a mess if the vendor or partner you’re using is not prepared,” says Michele Hibbert-Iacobacci, a Certified Clinical Coding Specialist, AHIMA member, and vice president of IS management and support for the auto casualty division at Mitchell International
Not the only project
Similarities do, of course, exist in the form of system remediation. Y2K required programmers to rework all the existing applications that rendered years with two digits and ICD-10 necessitates arming systems currently based on 5-digit ICD-9 codes with fields for 7 digits.
But Y2K was fixed by programmers, and a common estimate put forth by WEDI (Workgroup for Data Interchange) and others is that about 35 percent of the ICD-10 work will be handled by technology department workers.
That means training just about everyone in healthcare organizations before compliance day and ensuring they can operate in the new ICD-10 world after that deadline.
[Q&A: Why the U.S. actually needs those crazy ICD-10 codes.]
Mitchell’s Hibbert-Iacobacci will tell you she was around for the conversion from ICD-8 to ICD-9.
“ICD-8 was not an industry standard, so when ICD-9 was introduced, it was a phenomenon to try and get people trained,” she says. “The complexity of ICD-10 is really the downer for many because all the training and classes you go through, if you don’t have an anatomy and physiology background, you’re going to be left in the dust.”
And while Y2K arrived amid the technology and dotcom bubble, there was not a heaping pile of mandates, funded and otherwise, for most companies to meet alongside it.
“ICD-10 comes at a time with too many initiatives, limited resources,” says Deborah Kohn, principal of Dak Systems Consulting. “We’re starting to come out of the recession, and we’re heading into health reform.”
Likewise, the AHIMA conference comes at a point when healthcare organizations can no longer procrastinate the ICD-10 conversion — and at a time when it's clear that the comparison of Y2K to ICD-10 is a faulty one.
See also:
Will ICD-10 trigger an eleventh hour IT vendor conundrum?
5 ICD-10 takeaways from the front of the pack
ICD-10 arrives early in new CMS claims form
Why CMS' strategy of not testing ICD-10 is downright dangerous
