ICD-10 is coming. Are you ready?

Many changes to our American healthcare system are uncertain, but one change we can count on is a new medical coding system that drives healthcare payment and reimbursement. According to a mandate by U.S. Congress, the new system of International Classification of Diseases (ICD-10) will replace the current ICD-9 used by the American healthcare system by October 2013. The standard was endorsed by the World Health Organization (WHO) in 1990, and other countries began implementing ICD-10 in 1994. The U.S. is one of the last countries to implement ICD-10, a change that could cost hospitals up to $20 billion. Locally, the standard will change the way healthcare professionals work and bring a steep learning curve for those involved. What do these changes mean for our healthcare industry, and how can companies prepare for the changes?

In short, replacing the current ICD-9 system with ICD-10 requires more detailed and specific record-keeping. Each medical procedure and diagnosis has a specific code that insurance companies use to determine reimbursement rates. Three- to five-digit codes numeric codes will be replaced by three- to seven-digit alpha-numeric codes. Because ICD-10 enables the reporting of more detail, 24,000 diagnosis and procedure codes of ICD-9 will be replaced by 155,000 codes of ICD-10.

The overhaul of our nation’s medical coding system as a result of implementing ICD-10 could have an even greater impact and cost than did Y2K. The payor administration process and provider revenue cycle for every clinic and hospital will need updated IT systems, training for their people, and open lines of communication between administrative roles and medical professionals to enable a successful transition.

Although the change is not mandated until the year 2013, proactive steps in the near-term may minimize the potential costs of ICD-10 implementation. Every system will be affected, including electronic health record applications, computer-assisted coding software programs, and the daily actions of every generation of the healthcare workforce. In addition, professional coders will be required to have a greater understanding of Anatomy & Physiology (A&P) and medical terminology. Building a plan to address these changes and assess medical knowledge gaps can minimize the impact of productivity losses, reduced cash flow from erroneous coding, and prepare for investments in new IT systems and reporting requirements. While doctors will not directly report the codes, they will also be affected as they learn to communicate in a different way with their coders.

Now is the time to begin building your ICD-10 Implementation Strategy. As learning experts in the healthcare industry, Adayana is prepared to help address the growing needs that come from ICD-10. For more information, please contact Ryan Elliott at relliottadayana [dot] com (subject: ICD-10%20Article%20Online) .