For the past few years, providers have been shaking in their boots at the prospect of meeting the upcoming ICD-9 to ICD-10 conversion deadline. It is, after all, a pretty sizable project, demanding that providers and insurers switch out about 14,000 codes for about 69,000 codes. Not surprisingly, there was much celebration among concerned providers in April when President Obama signed legislation pushing back the ICD-10 compliance deadline date until at least 2015.
The American Medical Association, in fact, kept pushing HHS to repeal the ICD-10 mandate. At that time, the AMA was describing the ICD-10 switchover as a "massive unfunded mandate" which, according to Nachimson Associates, would cost small practices anywhere from $56,639 to $226,105 to complete.
This week, however, a new study came out which suggests that the AMA's cost estimates for the transition were greatly exaggerated. The study, which was published in the Journal of the American Health Information Management Association, found that ICD-10 transition costs are likely to be between $1,960 and $5,900.
Why were this study's transition estimates so much lower? Well for one thing, concluded researchers with 3M Health Information Systems, previous estimates had included costs related to EMR adoption and other initiatives which were not directly related to ICD-10. And in addition, previous estimates had relied on inpatient hospital data rather than studies of small physician offices.
Also, researchers said, providers are simply better prepared. 3M noted that clinician documentation and coding training manuals are now available at lower costs, and that the coding industry's knowledge in preparation for ICD-10 has grown.
Using codes is the real challenge
Actually, doctors and hospitals now seem more worried about how to function once the transition to ICD-10 is complete. According to a survey published by AHIMA earlier this month, 61% of providers think that documenting patient encounters will be more difficult under the new coding system and 54% believe that the new code set will make it harder to adjudicate reimbursement claims also.
Smart providers have already begun to focus on ICD 10 documentation and coding today, so they won't end up with serious cash flow problems due coding mistakes or backlogs. For example, at Fredricksburg, VA-based Mary Washington Healthcare, for example, every week coders code an account in ICD-9 as needed today, then recode the same account in ICD-10. Hospital leaders will gradually require coders to steadily do more dual coding over time.
MWH's revenue cycle management staff is also working with physicians to improve clinical documentation, as ICD-10 will require greater specificity in the past. The facility also has a clinical documentation improvement team in place which reviews patient records daily, asking providers for clarification as needed or providing feedback for improvement.
Certainly, some institutions will continue to struggle with the ICD-10 transition right up until the deadline, and lose money when they have to start using ICD-10 coding full-time. But really, given the increase in tools available to help and availability of good training, succeeding at the big, bad ICD-10 crossover seems to be within virtually any provider's grasp.