What the ONC Didn’t Discuss: Meaningful Use and the ICD-10 Overlap

The healthcare world has been abuzz about the Meaningful Use Stage 2’s final rule announcement.

It’s not that it was surprising – the ONC began foreshadowing the final rule about a year ago.  The final rule represents what many analysts consider to be important steps forward towards the overarching goal of health reform.

However, the ONC left a few things out in its announcement, which is why Power Your Practice is dedicating a series to addressing them. We begin with laying out the pros and cons of the overlap between Meaningful Use attestation and ICD-10 compliance.

Pros
With the ICD-10 extension and the recent announcement of Meaningful Use Stage 2’s final rule, the ONC has been a tad quiet on the subject of ICD-10. However, there are a few benefits to the overlap.

For instance, the criteria for Meaningful Use Stage 2 lays a foundation for ICD-10 implementation, and the data acquired via ICD-10 compliant providers will provide better results for Meaningful Use measures.

Usage of ICD-10 represents a larger number of codes to be used within EHR systems and push condition-specific patient tracking and enhanced epidemiology reporting, not to mention promote clinical accuracy. These benchmarks contribute towards meeting Meaningful Use Stage 2 requirements.

Also, native ICD-10 coding relies on structured clinical data, which also forms the basis of a number of EHR applications, namely disease registries, clinical charts, and discharge notes. Also, ICD-10 helps EHRs augment interoperability and electronic information exchange.

This level of structured documentation is laden with a number of Meaningful Use requirements. For instance, functional requirements for data capture in Stage 1 only cover 35% of the capabilities needed to meet 15 other criteria, much of which have been enhanced for Stage 2. Structured clinical documentation is required for the rest of these, thereby becoming essential to Meaningful Use attestation.

Cons
However, since the HHS announced a one-year extension for ICD-10 compliance, Meaningful Use Stage 2’s potential for disruption has been heightened.

Working to attest for both initiatives is daunting, and despite CMS’s best intentions, they don’t always gel well together. For instance, Meaningful Use attestation may mean you can’t modify templates as extensively, since attesting for both means adhering to the common standard and being rather compliant.

Also, even a small overlook of the ICD-10’s influence on coding, documentation templates, and even system logic when trying to meet Stage 2 requirements would be risky, resulting in rework, redundancies, and clinical errors. This can be seen as an avoidable error and CMS miscalculation.

Working towards both simultaneously may also threaten the stability of healthcare providers who would’ve benefited from wrapping up ICD-10 compliance first. This way, doctors would have more time to modify charts, instead of learning ICD-10 and changing up all templates at the same time.

In this sense, the logical progression of attestation places ICD-10 first, then Meaningful Use.

What do you think about the Stage 2/ICD-10 overlap? Let us know in the comments section below.


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