Do I Have to Transition to ICD-10? Yes, You Do!
(Editor's Note: This guest blog was written by Shelly Guffey and Dawn Duchek.)
The comment period on the proposed rule to delay ICD-10 closed on May 17, and the Department of Health and Human Services (HHS) is still in the process of reviewing those comments and deciding how the industry will proceed. Providers are uncertain about when ICD-10 will happen and whether they should continue moving forward with their preparations.
In some cases, practices are still confused about whether ICD-10 even applies to them. We keep hearing questions from specialty practices - dermatologists, OB-GYNs and orthopedics, for example - who are uncertain whether they should prepare to adopt ICD-10 standards. The short answer is yes, absolutely. ICD-10 will impact every medical practice, regardless of specialty focus.
For example, today an orthopedic practice uses the ICD-9 code 724.1 to describe a fractured shaft or humerus. When we convert to ICD-10, that practice will have about 40 unique, precise codes that will allow them to describe the cause, location and severity of the bone fracture. By reporting the injury to more exact specifications, the practice can better document and treat the patient's injury and will be more likely to be reimbursed appropriately for those services performed. The ability to reflect these small details within your diagnosis and procedure codes will be one of the greatest benefits of ICD-10.
So far, it seems like much of the conversation throughout the industry is about the inconvenience of switching from ICD-9 to ICD-10. While the transition will definitely demand an investment of time and dollars, there are actually a great number of benefits that providers will eventually reap from ICD-10. A whitepaper by Health Data Consulting outlines many of the positive impacts for providers and patients, and a few others are starting to direct the ICD-10 conversation to its opportunities rather than its challenges.
Here are a few improvements your practice will likely experience once ICD-10 has been implemented:
● Better documentation. As we mentioned earlier, the vastly increased number of ICD-10 codes will allow providers to document and track clinical data more accurately and consistently.
● Better financial and administrative performance. The ICD-10 code set will help practices improve their claims processing and reimbursement efforts by reducing the number of claims that are rejected or improperly reimbursed due to coding inefficiencies. It also will help practices collect more accurate payments, especially for procedures created since ICD-9 codes were defined.
● Better patient care. The industry's move to ICD-10 will standardize all patient data for diagnoses and treatments. With a standardized language and more accurate coding, physicians will be able to provide more appropriate care for patients and better identify each patient's specific conditions.
● Better policies and decisions. Consistent reporting of diseases across the industry will allow us to analyze public health trends and identify where we should direct research, dollars and policy reform to better address our most pressing health needs.
While it may be a few years until we see the positive impact of ICD-10, it is important to remember this transition will make practices more efficient and data more reliable, ultimately improving the quality of our patient care. And, the best way to reap the benefits of ICD-10 down the road is to continue to prepare now for its adoption.
Shelly Guffey is the manager of premier accounts and vendor partners at Gateway EDI. Dawn Duchek is the industry initiatives coordinator for Gateway EDI. For a compilation of helpful industry resources on ICD-10, visit http://www.gatewayedi.com/icd10/.