This will be a two part blog post. Check back in a few days for the remaining five issues.
It is well documented by now that there are several concerns surrounding ICD-10 and its impact on hospitals and healthcare enterprises across the country. In this article, I’m going to highlight five of those concerns to shed some light on what can be expected in the next two years.
A large portion of hospitals still have not completed a full assessment of the total impact of ICD-10; the industry readiness as a whole is staggeringly bad. Hospitals are taking the seriousness of ICD-10 too nonchalantly. Most aren’t quite sure how much their hospital will be affected until they see results – that’s when the shock sets in. Nearly ever department will be affected to some extent. A great example of how many departments and/or systems could be affected by the upgrade is the Kaiser Permanente Health System. After their assessment, nearly 190 systems enterprise-wide will need some sort of alteration when the ICD-10 upgrade takes place.
A second potential issue with ICD-10 is vendor readiness. While some vendors maintain that they are prepared for the transition, it is not definite that every vendor EHR will handle the transition efficiently. Some EHRs will not be totally compatible with ICD-10. This, in turn, could deem very expensive for the provider; Some may need to switch out their EHR so it works with ICD-10. While ICD-9 may fall short in many places diagnostically, ICD-10 will prove a success… in time. Hopefully most providers’ integration with their EHR does not pose a significant problem.
If your hospital or health system has a homegrown application as any part of its inventory or database, it could pose a risk in not being included in an assessment. Some departments are able to evolve their inventory without the watchful eye of their IT staff – so these types of applications could be easily overlooked. It truly has to be an enterprise-wide assessment in order to make the transition as smooth as possible. If your hospital does not have the internal resources to complete an analysis, partner with a consulting firm. While it may be more expensive, it could be more efficient and save you more time than doing it internally.
Productivity declines. What happens when a new system HAS to be implemented as mandated by the government – and that system basically wipes away experience from your coders? Their productivity will decline dramatically… at least until they are familiar with the new procedures and coding. Some hospitals have started training and knowledge programs for their coders in advance, so they can be more prepared for when the full implementation goes into effect. Some hospitals are even planning for smaller revenues from claims for the first year following ICD-10 since productivity will be down. The best thing hospitals can do right now is inform their doctors about documenting properly and training coders for what is to come with ICD-10.
Dual processing will more than likely be an issue with ICD-9 and 10. There will be a period of time in which both will be processing claims interchangeably. One might wonder, “Why?” Claims are based on the date of service, not the date of transmission. For example, a claim for service occurred on September 30th, 2013, a day before the cut-off date. However, it was dispatched on October 2nd, two days later. It would still go out in ICD-9, not ICD-10 – even though the new system had just launched. Because some claims may take months, practices and hospitals will have to deal with denied and rejected claims, hence another reason to prepare for smaller revenues.
