Survey finds ICD-10 transition mostly successful

Given that we’re more than two months removed from the ICD-10 code change over, we’re beginning to get some information on what that change has meant to healthcare organizations and, according to new information, the switch has taken a great deal of time and effort to manage. Of course, this is expected; no surprises here. The actual amount may be a little overwhelming, though.

According to KPMG, LLC, the ICD-10 change over cause a five-fold increase in the billing codes used in healthcare. And took many resources from IT, clinical and finance professionals. However, the survey found that 80 percent of organizations said the transition has proceeded smoothly.

So, despite the work involved, the transition was relatively hassle free and brings about memories of another major changeover from a recent yesteryear – Y2K.

“ICD-10 is the healthcare industry’s equivalent to the Y2K changeover in scope and has a profound influence on, not only the billing and reimbursement, but the ability to track quality of the delivery of healthcare,” said Todd Ellis, managing director at KPMG, in a statement. “This is an ongoing process, however, and this transition affects not just technology, but finance, employee training, clinical information, and other functions in healthcare.”

The survey included nearly 300 attendees of the November 9, 2015, webcast, “ICD-10: Just the Beginning,” which reported that 28 percent said the transition has been smooth and another 51 percent found “a few technical issues, but overall successful.”

About 11 percent described the transition as a “failure to operate in an ICD-10 environment.”

Survey respondents also said the largest challenges they see with ICD-10 include “rejected medical claims, clinical documentation and physician education, reduced revenue from coding delays and information technology fixes.” The survey also showed that 42 percent of respondents said all of these challenges are part of ICD-10. Only 11 percent of claimants said they did not expect those challenges to arise.

The ICD-10 (International Classification of Diseases, 10th Revision) represents a major move up in the number of codes offered, expanding the number of diagnostic codes to 68,000 from 13,000 set more than 30 years ago. Accordingly, the increased number of codes are meant to allow greater insights into reimbursement and the quality of care.

Catherine O’Leary, KPMG managing director, said in a statement that the first few weeks of the transition have been smooth with only limited technical difficulties, but “providers will need to dedicate more attention to the quality and specificity of clinical documentation to reduce rejected medical insurance claims.”

However, “organizations are beginning to see dips in cash flow because of payers delaying the processing of ICD-10 claims while they ensure their ability to appropriately adjudicate these claims, while others are seeing an increase in claim denials over pre-ICD-10 levels” said Craig Greenberg, KPMG director, advisory, in a statement.

“While there seems to be a fairly smooth transition to ICD-10, the 11 percent of organizations that are struggling need to be helped,” Ellis added in a statement. “The communities these organizations serve depend upon their healthcare providers to meet their medical needs and we need to help them through these challenges. ICD-10’s implementation was a lengthy process and unfortunately they will address these issues or face greater competitive disadvantages in measuring quality and reduced cash flow.”

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Scott Rupp

Contributor

Scott E. Rupp is a writer and an award-winning journalist focused on healthcare technology. He has worked as a public relations executive for a major electronic health record/practice management vendor, and he currently manages his own agency, millerrupp. In addition to writing for a variety of publications, Scott also offers his insights on healthcare technology and its leaders on his site, Electronic Health Reporter.

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