Dive Brief:
- According to a study published in the journal Pediatrics, transitioning from ICD-9 to ICD-10 could result in a significant loss of payment in clinical data for pediatricians and other low-margin practices.
- To conduct the study, researchers at the University of Illinois identified 2,708 Medicaid ICD-9 codes used throughout the state in 2010 and matched them to pediatric primary care patients in the University of Illinois's Hospital and Health Sciences System.
- Overall, the researchers found that 26% of translations were convoluted, which would lead to an estimated 8% risk of losing financial and clinical information during the transition ICD-10.
Dive Insight:
Despite the potential for losses, the coding transition is likely to offer important benefits over time, according to the study's authors. But over the short term, pediatric practices should beware: They typically function on a narrow financial margin in which the 3% to 5% of codes resulting in billing errors could have a significant financial impact.