Note: As of April 2014, Congress managed to delay ICD-10 yet another year. Read all about it here:
ICD-10 delayed until 2015

From our healthcare preparedness review of the pending transition from ICD-9 and ICD-10 coding with only months left before full implementation, many practices are still somewhat disorganized and not well prepared for that undertaking. The first steps are:

  • Make sure the clinical documentation is the best it can be since so much of the ICD-10 coding will rely on better medical records
  • Train coders
  • Practice, practice, practice – coders will need to practice before initiating the full blown coding for reimbursement process
  • Set up an accuracy processes and oversight to make sure coders understand and are using the ICD-10 codes correctly
  • Make sure software will do the job with the new data sets and test the system until it is seamless and test it to make sure it all works

Recommendations are to have coders do both sets of codes starting now. They should code both ICD-9 and ICD-10 on every chart. This entails extra work and may obviously require more coders since they will lose at least half of the coding production time. Indeed, we have found the ICD-10 coding process takes more time than its predecessor as well. More coders will increase costs, but the investment is a good solution.

The loss in productivity is an absolute but taking the time now to set up a reliable system will mean successful transitioning now set in 2015.

The projected costs estimated for this transition by the Department of Human Services are an astonishing $1.64 billion, including $357 million for staff training; $572 million anticipated losses and $714 million for system IT changes. The offsets to the costs are (according to HHS) a cumulative benefit of $87.7 million in annual savings, but the breakeven point won’t happen until 2018. Health care organizations will certainly feel the economic impact and will be looking for other ways to support the shortfall.

The bottom line is that many healthcare providers still do not fully understand the implications of the economic facts and have not delegated workable approaches to streamline the process, make sure it works and strategize plans for the shortfalls.

Keep in mind that payers under the ICD-10 platform will have better quality data for measuring quality of care and negotiating contracts with initiatives and performance-based payments.

Training is available for both ICD-9 and ICD-10 (in parallel coding practice) at www.med-certification.com.