ICD-10 Implementation Delay – Varied Responses from Providers

by | Published on Aug 11, 2014 | Medical Coding

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The healthcare industry’s response to the postponement of ICD-10 standard for medical diagnosis and billing codes to October 1, 2015 ranges from relief to resentment. While those healthcare providers who were not fully prepared for the radical format transition are relieved, those who worked fully to meet the deadline are quite annoyed about the delay.

However, a recent study (conducted in May and June, 2014) found that most of the providers are very well utilizing the 12- month ICD-10 stay to prepare more for the new medical coding standard. The study conducted by eHealth Initiative and the American Health Information Management Association (AHIMA) surveyed around 349 healthcare organizations, vendors and consultants. It was found that most of the organizations are taking full advantage of this delay in different ways. This includes 60% using the extension deadline to improve medical record documentation integrity, 61% are training more number of staffs, 47% continuing dual coding and 40% conducting more robust testing. Around 33% have used this delay period to reallocate resources.

With this study, researchers aimed to measure the potential effects of the delay on those organizations that were continuously working to meet the previous deadline of October 1, 2014. In an attempt to alleviate the total productivity loss, about 68% of survey respondents plan to carry out extra training and practice and 31% look forward to hiring more coders to help with the eventual transition process. Other key findings of the survey include –

  • About 40% plan to begin end-to-end testing by the end of this year
  • About 25% plan to initiate this process by the end of 2015
  • For those organizations that are not planning end-to-end testing, more than 41% say that they had no knowledge of how to perform the testing

As per officials from the Centers for Medicare and Medicaid Services (CMS), each single day delay of the ICD-10 coding system can prove to be expensive and have multiple effects on potential costs.

  • Around 50% of respondents reveal that a 1 year delay would increase costs by 11- 25%
  • Around 37% of respondents feel that a 1 year delay would increase costs up to 50%
  • About 67% of respondents feel that the possible delay would not improve readiness
  • About 69% of respondents say that a 2 year delay would be potentially catastrophic

Researchers say that ICD-10 is a natural extension of meaningful use of codes. The transition will require healthcare providers and insurers to understand the 69,000 codes in the place of the earlier 14,000. ICD -10 adds more specificity and reduces ambiguity of codes which may lead to better communication resulting in quality patient care. More than testing this new code system, healthcare organizations need to optimize workflow, provide adequate training to users and prepare for better documentation.

Certain providers feel that a full implementation of this system could hurt their bottom line. The study results found that around 6% feel that ICD-10 will increase revenue, 38% fear revenue will decline and 14% say revenue will remain flat. However, 65% of organizations plan to use this specific code set for medical billing and claims processing, 62% for quality improvement and 51% for performance measurements.

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