ICD-10-AM: 7 things we can learn from Australia's ICD-10 implementation

Carl Natale
by Carl Natale

The United States is not the first country to transition from ICD-9 codes to ICD-10 codes.

In 1998-1999, Australia implemented ICD-10-AM. (AM stands for Australian modification). Australian healthcare organizations adopted a staggered implementation. Some states went first. One of the last to implement was Queensland, which is where Debbie Abbott was a certified health information manager. She was the ICD-10-AM implementation officer for Queensland Health, which covered about 200 hospitals and ambulatory healthcare facilities.

Abbott explained her experience in the webinar "ICD-10: The Australian Experience" on Tuesday.

Australian healthcare has some similarities to the U.S. system. For example, they a private/public healthcare system. Citizens can get government run healthcare or buy their own insurance.

There are some differences that seem to make ICD-10 implementation less painful in Australia. Australian hospitals have a single DRG, and they are only using ICD-10-AM for inpatient coding. But they are moving to outpatient coding also.

Nonetheless, Abbott has some takeaways we should note:

  • The Australians love ICD-10. They're not working with so many "dump codes" because ICD-10 translates so well to their DRG.
  • Medical coders were back to old output rates (That's Australian for productivity) in three months.
  • Education is key. They started training everyone 18 months from the deadline. Abbott credits that with returning medical coders to productivity so soon.
  • Anticipating problem areas is also important. Testing sooner than later should show you where you need more education and workflow changes.
  • It's a major undertaking to identify all the stakeholders. That's why a lot of consultants want to see how an ICD-9 code is used in a practice. That will demonstrate who needs to know what.
  • It's expensive. Australian vendors are capitalists too.
  • Australian providers still are adjusting their billing because of what they're learning from their ICD-10 data.

Probably the most important thing we can concentrate on is education. Not just learning what's the ICD-10 code for a sprained wrist. But providers need to learn where ICD-10 implementation can cause the most trouble and make the necessary changes.