On Aug. 22, the Department of Health and Human Services set the long-awaited implementation of ICD-10 into motion with a Notice of Proposed Rulemaking (NPRM). Since then, the American Health Information Management Association (AHIMA) has been working to prepare facilities and organizations for the large-scale, long-term shift in coding practices. Throughout the 2008 Convention and Exhibit, AHIMA leaders urged members to get informed about ICD-10 policies and procedures and make suggestions before the ICD-10 comment period closed on Oct. 21.

AHIMA held a press conference on Oct. 13 to announce the association's official position on ICD-10. AHIMA CEO Linda Kloss, MA, RHIA, spoke first and expressed AHIMA's full support of the transition to ICD-10. "We are a decade behind the rest of the world in this vital element of patient care and control, and that is just not acceptable," Kloss explained.

According to Kloss, ICD-9 codes are no longer sufficient for the current state of health care, and continued use of ICD-9 will have a detrimental effect on decisions regarding patient care. "Medical knowledge and health care information are not static," Kloss said, "but with ICD-9, we've held them static for nearly 30 years."

Stressing the need to move forward with ICD-10, Kloss said further delays will only result in higher long-term costs. The longer America waits to act, Kloss added, more programs and software will eventually need to be converted to ICD-10, which carries a high price tag. Kloss admitted that implementation will require initial investments, but the lasting benefits will far outweigh start-up costs.

Kloss advocated for the transition to ICD-10 as a means to incorporate the United States into a "stronger international health care community" that promotes improved patient outcomes, expanded research opportunities, lower health care costs and a healthier population overall.

AHIMA senior vice president of advocacy and practice leadership Jill Dennis, JD, RHIA, previewed some of the actions AHIMA plans to take to prepare everyone for the switch to ICD-10. "AHIMA is already actively working to help facilitate this transition, and not just for our members or the HIM profession, but for the entire health care industry and, most of all, our nation's health care consumers," Dennis said.

With a goal to lead the industry in ICD-10 education, AHIMA is adding new resources to its Web site for anyone to learn more about the transition, Dennis said. AHIMA is also developing a 2009 summit that will address the new coding system. While AHIMA plans to update academic curricula and coding certification requirements and establish training programs to complement the move to ICD-10, Dennis warned organizations and facilities against training too early. "Training is more effective if done relatively close to the implementation date," Dennis said, suggesting 6-8 months prior to the system's launch.

Ultimately, Dennis concluded, AHIMA is focused on "minimizing disruption and maximizing the value" of ICD-10.

Following their official statements, AHIMA leaders fielded questions about the change. Kloss expressed confidence that AHIMA's position reflects the interests of its members and said America's health care system has the ability to complete the transition to ICD-10 within 3 years of the final rule. However, implementation will depend upon establishing a set date for the final rule, Kloss added.

AHIMA vice president of policy and government relations Dan Rode, MBA, FHFMA, said the current goal is to issue a final rule by the end of 2008 or no later than Jan. 15, 2009, before the administration changes.

Regarding cost, Dennis reiterated that ICD-10 will save money in the long-run. "The costs don't get any smaller as we push it out to the future," she said. 

Launching into its proposed leadership role, AHIMA offered several opportunities for HIM professionals to get informed about ICD-10 during the 2008 convention. Pre- and post-convention sessions provided background and preliminary coding tips, while the ICD-10 update on Oct. 13 was a well-attended session. The following afternoon, an ICD-10 town hall was offered as part of the "hot topics" track and invited HIM professionals to express concerns about the change.

Rode was on hand again, encouraging attendees to read the NPRM, submit comments and play an active role in the transition. "We need the industry represented by those who want to move forward today," he added.

Lynette Czarkowski, MS, RHIA, AHIMA's senior vice president of HIM professional resources, presented an outline of the overlapping stages HIM must complete to successfully implement ICD-10. Czarkowski said educators and trainers should begin preparing now by increasing awareness and understanding of the new coding principles. Next, students must learn how to code using the new system and data managers should understand the impact of new codes. Finally, coding personnel and providers will need training so they can "spring into action" when ICD-10 launches.

Audience members expressed similar concerns about the time and cost associated with the change. The panel estimated a return to productivity in 6 months, based on other countries' experiences. Anticipating the added strain ICD-10 may put on those currently enrolled in educational programs, the panel called for volunteers for an academic work group to establish a practice brief and program instruction to guide future curricula.