Look Out, Here Comes ICD-10

On Oct. 1, 2015, the current International Classifications for Diseases (ICD) system, ICD-9, a 30-year-old system for medical and billing codes, will convert to the new international standard ICD-10. The most notable change is the significant increase in number of diagnostic and procedure codes from 17,000 to more than 140,000.

Despite what was first believed to be modest changes in the former coding system proposed in 2008, the upgrade to ICD-10 is looking to be a much more fundamental change. This will affect more than just practice coding operations, but also reporting, administration, registration, and just about every other office or hospital department. Everyone is affected: providers, vendors, and payers.

This isn’t a Band-Aid on a blister; it’s major surgery.

In 2008, Nachimson Advisors LLC conducted a study to assess the potential costs and consequences of the ICD-10 transition. Their report estimated that the ICD-10 upgrade costs would range from $83,290 for a small, three-physician practice to $2.7 million for a large 100+ physician practice.

The report noted that not only were transition costs a factor, but there would also be other concerns that would significantly affect healthcare providers, like staff training and coordination, transition time demands and complications, and the mental and emotional strain on such an ambitious conversion. Everything would be disrupted.

According to the American Academy of Orthopaedic Surgeons (AAOS), who commissioned the report, “Data from Canada, which converted to ICD-10 between 2001 and 2003, indicate that productivity declined by 10 percent in the year before and the year after implementation. It took an average of 6 months for most healthcare environments to return to an acceptable productivity level.”

But just when you thought things couldn’t get any worse, they didn’t. As more providers have moved toward compliance, the costs, concerns, and complications have actually been more manageable than expected.

In their “Survey of ICD-10 Implementation Costs in Small Physician Offices,” Karen Blanchette, MBA; Richard Averill, MS; and Susan Bowman, MJ, RHIA, CCS, cited a survey conducted by the Professional Association of Health Care Office Management (PAHCOM) which stated that not only were the costs significantly less than initially expected, but transition times and overall practice disruption wasn’t as ominous either.

The PAHCOM survey – which is significant because it contacted actual practices using actual expenses incurred – concluded that in the 176 practices interviewed (all under six providers) the average ICD-10 expenditure was $8,176, with average costs per provider decreasing as the number of providers per practice increased.

Not only were costs less than expected, but so was implementation time. When total amount of time used in transition was asked, including physicians, office management and support staff, on average, the combined amount of hours expended across personnel type in practice with six or fewer providers was 45.5 hours per provider. The lower costs reported in this survey were in part due to the fact that actual costs were included, not estimated. Other contributing reasons are that educational material is now readily available online at nominal to no cost, and that many software system vendors are providing ICD-10 system updates at no additional cost.

The reality of the situation is that the ICD-10 deadline is coming, and all providers must comply and need to be prepared. How each practice handles the transition on an attitude, staff, resource, and procedural level will likely determine whether it’s a smooth, inexpensive change or a major headache.

Knowing that added expenses and transitional challenges are on the way, there are many optimization tools that practices can employ to proactively confront these issues in addition to streamlining office procedures. Opargo, which identifies doctor appointment types, times, and tendencies, and then books them based on office priorities, has been proven to improve efficiency, minimize expenses, maximize staff and resources, accelerate revenue, and provide patients with greater quality of care.


The Impact of Implementing ICD-10 on Physician Practices and Clinical Laboratories

Survey of ICD-10 Implementation Costs in Small Physician Offices

Posted in: Policy