Warning: 3 Major Pitfalls for the ICD-10 October 1 Release

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OCTOBER, 2015

Healthcare Integration

October 1st marked the day that ICD-10 went live and for some, it’s been a long time coming, but for others the “wait and see” approach might end up being more costly.

As we all know, the change from ICD-9 to ICD-10 went from some 13,000 codes to about 68,000—which sounds daunting—but with an organized plan and focus of resources, it should be attainable. However, if you’re unprepared there are three major pitfalls that you might encounter.

Getting Paid

Hospitals, just like all businesses, rely on getting paid, and in a timely manner too. If you are late in the switch to ICD-10 or have coding errors, this could result in delayed payments from payers, but also could result in denied claims to patients. This is one of the reasons why having the correct codes in place matter to both your organization and your patients. In a recent survey conducted by the Medical Group Management Association, 20% or more of physician practices have not received the billing system updates necessary for ICD-10 which could negatively impact the patient claim submission process.

Productivity

With the changeover to ICD-10, organizations need to focus time and resources to getting their codes in order so they can expect some dip in productivity or attention to other projects. Organizations should mitigate this by either budgeting out the expected time, or bringing in external resources they can focus on other projects that are slated for years end. If you have put off the necessary work involved, it can really eat up valuable time and resources while pushing back other necessary projects.

Vendor Readiness

While your organization might have been ready for the October 1 date, your vendor might not have been which directly impacts your success. Not only can you experience the pains of their coding, but a lack of training with internal staff can also slow you down. Your vendor should provide access to both ICD-9 and ICD-10 codes for coding purposes through the transition, and they should provide support for this, but if they don’t due to a contractual misunderstanding, this might become a major issue.

While we hope the transition is a smooth one, unfortunately, we know that will not be the case for everyone. Internal resources can be thin due to the number of backlogged projects, so bringing in outside resources is can be a viable necessity to get over the hump. If it is adding a consultant to focus on the ICD-10 needs or augmenting your staff to allow your internal team to focus on ICD-10, let Core Health Technologies pick up the slack!