Expect a productivity decline as you implement ICD-10

The major impact you can expect to see in your practice due to ICD-10 is a drop in productivity.

The code sets associated with ICD-10, provided by the Centers for Medicare and Medicaid Services and the National Center for Health Statistics, are not a simple update. Rather, they adopt changes in structure and concepts that differentiate them greatly from ICD-9. In fact, this change will increase the number of codes from 17,000 to 140,000, including clinical modification (for diagnoses) and procedure coding system codes (for inpatient care).

In 2014, when ICD-10 takes effect, mastering the new code set will take even seasoned coders longer than it took to conquer ICD-9. Don’t expect efficiency to normalize immediately following ICD-10 implementation, as payer interpretation of the new coding system will adversely affect productivity. Financial risk may be more favorable for either the payer or the provider, depending on which is better prepared to take on ICD-10.

Productivity will be affected for all participants in the healthcare system:

• Physicians will be required to provide more detailed documentation related to disease etiology, anatomic site, and severity; healing stages; weeks in pregnancy; and episodes of care.

• Practice managers will have to establish a budget, create initial and ongoing training agendas, and review contracts to determine the impact of ICD-10.

• Nurses and laboratory staff will need to deal with revised forms, provide increased documentation, and learn revised authorization policies.

• Billing, coding, and front-desk personnel will be confronted with a new advanced beneficiary notice based on local and national coverage determinations; the need for updated and more complex super bills and encounter forms; and the increase in the number of codes.

ICD-10 also will require greater knowledge of anatomy and medical terminology.  Although the changes are extensive, the government believes this approach ultimately will lower costs and improve healthcare quality.

The author is an associate director at SS&G Healthcare, Akron, Ohio.