ICD-10 Post Launch – Cautiously Optimistic
by Millis Blackburn Perry RHIA, CCS, CPC
The implementation of ICD-10 has at last happened after decades of development, the frustrations of enduring repeated last-minute delays, and the never-ending regulatory hurdles to move beyond. It is estimated that nearly $30 billion in costs have been incurred to plan, train, and convert systems, test and prepare for ICD-10. Those of us who are in the medical coding profession are truly a part of U.S. healthcare history as we have seen the sunset of ICD-9 and are now assigning ICD-10 codes to the patient encounters we work with each day.
The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) is a revision of the ICD-9-CM system which physicians and other healthcare providers currently use to code all diagnoses, symptoms, and procedures recorded in hospitals and physician practices. The ICD-10-CM revision has more than 68,000 diagnostic codes, compared to the 13,000 found in ICD-9-CM. The revision also includes twice as many categories, and is more specific in identifying treatment. For example, ICD-10 provides codes to distinguish between a left or right leg; ICD-9 does not.
Our U.S. healthcare industry will now begin to appreciate and understand the enormous benefits that ICD-10 brings to us. Some of these benefits include: fewer claim rejections with more accurate payments, more precise assessment of the quality of care provided, better detection of fraudulent claims, fewer requests for additional patient information, more effective disease management, a better understanding of efficacy of new technologies, and a greater ability to detect new and emerging health threats.
The next phase is to see what “aftershocks” occur and what challenges they may present. We will watch closely to see the trends in reimbursement, front-end rejection rates and back-end denial rates. With only a few weeks of data available, the initial reports are cautiously optimistic and some healthcare organizations are reporting a smoother transition than originally thought. This is in great part attributed to the many months of dual coding and working with the clearinghouses and insurers on testing claims submission.
Hopefully the predictions of substantial increases in account receivable days, delayed payments and the 30 – 50% in coder productivity will prove to be overestimated.
You can reach Millis Blackburn Perry, RHIA, CCS, CPC at email@example.com