ICD-10: Smooth Sailing and Sunny Skies Ahead?

Coding and BillingNo Comments

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It’s been 6 months since the long-awaited implementation of ICD-10. Was the transition as painful as we all thought? Let’s check out its effects on the healthcare industry so far.

Avoiding doom, gloom, and chaos
Thankfully the anticipated system failures, loss in revenue, increase of denials, and cash-flow crunches have yet to materialize with the swap to ICD-10. Instead of chaos, industry experts are reporting a pretty smooth transition and an overall improvement in the quality of clinical documentation.

ICD-10 trainer Deborah Grider attributes the successful transition to the preparation of hospitals in providing education and focusing on clinical documentation improvement. However, Grider warns, the transition is not over yet. Over the next 6-12 months, additional challenges may pop up due to denials and delayed claims.

Jose Rivera, vice president of healthcare solutions company Visiquate, agrees that the industry was well prepared for the transition. He deems it a success despite small initial difficulties: unsurprisingly, it took a few weeks for physicians to become faster at choosing the right codes.

Productivity loss
Many feared that the U.S. healthcare system would experience a 40% loss in productivity because of ICD-10. But by February it became clear that these fears were exaggerated. According to a healthcare billing and management survey, 22 of 38 participating billing companies reported a 25% loss in coding productivity with the rest reporting no loss. While any loss in productivity hurts, this stat will only improve with time.

Financial impact and denial rates
MedPage Today studied the monetary effects of the first months of ICD-10 and found little lasting financial impact. There were no changes in account receivable cycles, authorization denials, or hospital’s cash on hand. However, there was an increase across the board in medical necessity denials, some even doubling. This rise in denials—which has increased every month—could mean that revenue disruption is around the corner.

The Centers of Medicare and Medicaid Services (CMS) has offered a one-year grace period as everyone works to improve their specificity in coding. But with the relaxation period set to end on October 1, will providers be ready? As an ICD-10 pro, you can make sure that your company is on the right track in the new system.

Interested in mastering ICD-10? Enroll in a training course today and become a vital part of the healthcare industry.


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