Ready or not, ICD-10 is here. After multiple delays and much debate, the compliance date of October 1, 2015 has arrived. The health care industry must now begin using the new International Classification of Diseases diagnostic codes, updated for the first time in over 35 years.
As providers struggle to come up to speed with the increased classification options of ICD-10, growing pains are inevitable. However, most of the discussion about the implementation of ICD-10 has focused on the financial and administrative impact on doctors and medical practices. What about patients? How will ICD-10 affect them? And is it possible the changes might even improve patient satisfaction?
First, the bad news
Critics of ICD-10 claim that an even more complex coding system will make the billing process even more troublesome. Since incorrect diagnostic codes are a common reason for denying a claim, the critics predict that denials will go up and appeals to health insurers will only add to the burden on medical practices—and annoy patients who could experience long wait-times to determine eligibility before scheduling services and receive bills for procedures that were not covered.
Yes, there will be glitches, writes Tom Sullivan, editor-in-chief of Healthcare IT News. “Problems will arise, claims will be denied, clinicians will grow impatient with the new classification system and a dip in coder productivity is inevitable.” However, he adds, “it doesn’t mean we’re in for a total disaster here either.”. Consider the uproar leading up to Y2K, which ultimately turned out to be a nonevent.
A glimmer of good news
Because ICD-10 compliance is mandatory and in effect as of October 1, 2015, doctors have no choice but to accept it—and they might as well focus on the positives, however small those may seem to be.
One glimmer of good news is that while most health care providers say the changes will negatively impact them, more than half say ICD-10 won’t affect their patients at all. And some even say it will benefit patients. An August 2015 study by Porter Research, commissioned by billing solutions provider Navicure, found that 65 percent of responding providers believe the impact on patients will be neutral, and 9 percent feel it will be positive/very positive.
Patient satisfaction surveys show that even if patients are happy with the care provided, if they receive a medical bill that is unexpectedly high or they don’t understand what they’re being charged for, their satisfaction with their provider takes a big hit.
ICD-10 could positively impact the revenue cycle by helping both patients and providers anticipate and understand up front the costs for different treatment options, as well as getting estimates and bills out quicker, said Judy Hanover, research director at International Data Corporation (IDC) and author of the report, “U.S. Healthcare Provider Predictions for 2014,” to Healthcare IT News.
Lastly, there are the long-term, big-picture benefits that proponents of ICD-10 have been touting: the new codes will generate more detailed data that will lead to improved patient safety and outcomes. “ICD-10 improves the accuracy of claims, quality of care, and patient safety. It makes managing population health and conducting clinical, health services, or translational research easier,” states the American Health Information Management Association. AHIMA has created this infographic to further explain the benefits of ICD-10.
What you can do now
However you feel about it, ICD-10 is here to stay, so you’d better get on board. If you haven’t done so already, you’ll need to upgrade your systems and make sure they are using the most recent version of ICD-10 codes. Identify and standardize the ICD-10 codes you’re most likely to use in your practice to streamline the eligibility and approvals process for patients.
As you move forward, monitor and measure coding and billing productivity, and analyze claims denials to make appropriate adjustments. Fully implementing ICD-10 will likely take several years, so the key is to remain patient and have systems in place to identify and fix problems. Ongoing staff training is important; the burden shouldn’t be solely on providers.
The right technology can streamline your practice and take time-consuming tasks off your plate as you adjust to ICD-10, and can also have an impact on patient satisfaction.
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