ICD-10 is expected to be implemented on 1st October, 2015. Despite how far it sounds, providers are running short of time to prepare their practices for the new coding system. In contrast to the existing ICD-9 coding system, ICD-10 is much bigger.
All the coding experts who are well versed with ICD-9 codes will have to go through training for the new coding system from scratch. The latest version of ICD-10 contains over 68,000 codes, as compared to the 13,000 ICD-9 codes. However, it is not necessary to memorize all these codes, especially for small and medium sized physician groups, who should only be concerned with codes related to their particular practices. The major impact of ICD-10 will be on the following key areas:
1. Financial sustainability
CMS experts are of the view that a decrease in cash flow and revenue will follow the implementation of ICD-10. They have predicted that claim denial rates could increase by 100 to 200 percent and revenue of healthcare organizations could witness declining payments for at least two years post implementation. Pershing Yoakley & Associates, P.C (PYA) identified seven key areas of the continuum of revenue cycle management that organizations must focus on to Prepare for ICD-10. These include updating and testing IT software, adjusting account receivable reserves, preparing for future delayed payments, and keeping track of expected denials.
2. Workforce
Arrival of ICD-10 will not only be troublesome for coders, but for office staff as well. Preparation for ICD-10 can indirectly affect front-end tasks like patient scheduling, pre-certification, pre-registration and case management functionality. So other than coders, office staff must also be well-educated and trained to deal with the new coding procedures.
3. Provider and Vendor Readiness
Although the implementation date for ICD-10 was announced a long time ago, some providers are still stuck in the planning and strategy implementation phase of ICD-10. Moreover, there are others who have not yet established their ICD-10 budgets. Vendors on the other hand are also exposed to a high level of risk when it comes to ICD-10. Providers must ensure that their vendors have upgraded their IT systems and trained their workforce to be ICD-10 ready. Failure of vendors to be prepared for the new coding system is an indication that providers need to look for a new vendor who is capable of meeting their needs.
With so many issues, you’re probably wondering ; why go through the hassle of implementing ICD-10 for your practice? Michael Wilson, Chief Executive of Healthcare information Management (HIM), said that the new ICD-10 diagnosis and procedural codes will lead to accurate payment of new and better procedures, improved administrative performance and enhanced patient care. Other benefits for providers after the twoyear trouble post ICD-10 implementation will be greater efficiency, fewer fraudulent claims and more accurate reimbursements.
