An Update on the ICD-10 Transition

Posted by Team PracticeForces on Apr 7 2016

It has been about six months since the transition from ICD-9 to ICD-10. Since then, there have been a number of important lessons learned, and a few updates to share.

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Fears About the Number of Codes Were Unfounded

Before the update, we wrote a blog post on the transition. We noted:

"The ICD-9 system had approximately 14,000 codes, while in ICD-10, the number has increased to more than 69,000 codes. Now, everyone seems to be concerned with the huge number of codes, but this concern should not be blown out of proportion... The important thing to note here is that though the set of codes has increased dramatically, you will NOT use all the codes. In fact, each practice ... will need to use only a small number of codes."

This turned out to be true. Although physicians and other staff are sometimes confused about ICD-10 codes, the problem isn't much worse than it was with ICD-9. In fact, ICD-10 corrected some outdated nomenclature that led to coding problems. Many physicians have placed laminated sheets in their offices with the most common codes used by their practice, because that's simpler than scrolling through a bottomless drop-down menu.

The Frequency of Claims Denials Has Stayed Steady

A RevApp study conducted during the first three months of ICD-10 implementation determined that accounts receivable cycles and authorization denials barely changed. Although selecting the wrong code is still one of the main reasons for insurance claim denials, the problem doesn't seem to be much greater with ICD-10 than it was with ICD-9.

Why did ICD-10 turn out to be more of a bump in the road than a major catastrophe? Largely because hospitals and practices were overprepared and focused on the importance of the change. For Chris Zaenger, of Z Management Group, in Elgin, Ill. and president of the National Society of Certified Healthcare Business Consultants, compares it to the Y2K shift 16 years ago. Coders worked furiously for months leading up to the year 2000 to prevent computer malfunctions, and the extensive preparation compared with largely unfounded concerns resulted in something of an anticlimax.

Even More New ICD-10 Codes Are Coming

Another 5,500 codes will be added to the ICD-10 diagnostic library on October 1 of this year. These codes, proposed by the Centers for Medicare nad Medicaid Services, will relate to the following diagnoses:

  • cardiovascular and lower joint body issues
  • diabetes
  • face and hand transplant
  • donor organ perfusion
  • mental health disorders

Once you've finally gotten used to ICD-10, the new codes might have you diagnosing yourself with F43.20, Adjustment Disorder. If your practices focuses on any of these areas and you're worried about how to manage ICD-10, now would be a great time to consider outsourcing your medical billing.

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Topics: Medicare, ICD-10 Transition, ICD-10, ICD10,

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