Impact of ICD-10 on Healthcare Providers

ICD-10-CM will affect both physician and hospital services whereas ICD-10-PCS will only affect reporting of hospital inpatient services.

Similar to payers, physician practices will need to make system modifications or enhancements. Hospital Information Systems (HIS) and Practice Management Systems (PMS) will be affected as well as EHRs. In addition, other systems such as patient scheduling, may imbed ICD throughout the processing logic. To fully understand the impact of required system changes, health care providers should perform a complete system assessment.

Providers should interview vendors whose systems have ICD impacts to determine their readiness. Vendors who do business internationally may already accommodate ICD-10. Other vendors may have plans to upgrade systems by the compliance date. A third group of vendors may not have plans to upgrade due to the age of the system or technology. For systems that fall into the latter category, an alternative technical solution must be sought. The vendor selection process and implementation of a new system can take time, making the initial system assessment an important task to perform early in the process.

Additional system impacts include:

Implementing new technology to assist with code assignment because of the large number of ICD-10 codes

Maintaining both ICD-9 and ICD-10 for a period depending on the needs of the individual practice

The ability to resubmit an increased number of denied claims due to errors on both the payer and provider side

Health care provider workflow may change to accommodate new technology. Documentation such as physician practice "superbills" which list diagnosis and procedures routinely used to treat patients in that practice will require changes to support the new coding structure.

Due to the coding, system, and process changes, training of health care provider staff members is critical. Clinicians will require training to improve documentation to reflect complete and detailed descriptions of medical conditions and services. This will allow the coding staff to code for medical records and claims submission accurately.

Because of the complexity of the new coding system and potential implementation of new technology, now is a good time to assess the skills of staff members. It may be necessary to develop skills in disease pathology or pharmacology, anatomy and physiology, and computer skills.

Health care providers may experience a decrease in staff's productivity due to training, learning curve of transitioning to the new coding system and new technology, and reprocessing denied claims. Because of this impact, existing staff may need to work extra hours or temporary staff may be required to maintain currently workload while permanent staff is trained.

Impact of ICD-10 on Healthcare Providers

By: gssmktng

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