WASHINGTON – The anticipated change from the ICD-9 Medicare physician and hospital billing code systems to ICD-10 could cost healthcare providers a hefty amount of money, effort and time and could result in lost reimbursements if not done right, experts warn.
Providers will need new software and perhaps new computer systems. And they’ll need time to map from one coding system to another and train staff, said Sheri Poe Bernard, head of the American Academy of Professional Coders national advisory board.
Deborah Grider, a healthcare consultant at Deborah Grider & Associates, LLC, in Indianapolis, said the transition could cost the typical 10-physician practice somewhere between $70,000 and $80,000.
Because the adjustment will require so much time and money, Bernard and Grider urge physicians and hospitals not to put off getting ready for the upcoming change.
The federal government is expected to set the transition date soon – and it could be as early as October 2010, Bernard said.
Providers should be setting up a committee to plan the transition and include stakeholders, finance and coding departments and clinicians, Bernard said. Providers should also assign a leader responsible for the organization's preparation.
"There needs to be someone with the ICD-10 transition on their radar screen. There's so much that can go awry," Bernard said. "I think that most coders are aware of the change to come, but many IT folks are unaware. The information is not getting disseminated to people who need to know."
The increased granularity of the coding and the sharp increase in the complexity and number of codes themselves will be "pretty stunning," Bernard said. "The last time we had anything this big was 30 years ago when ICD-9 codes were first required on paper claims."
According to Grider, most doctors will probably need to learn a more extensive way of documenting their work or risk losing reimbursement under ICD-10.
Grider, who conducts trainings on ICD-10, said doctors should be trained now and given time to practice the new documentation before ICD-10 kicks in. In addition, practices should undertake internal audits every six months to assure documentation is correct before the new coding is required.
"Providers are in shock when I talk about ICD-10," Grider said. " Doctors don't think it’s a problem until it's upon them."
Do you think it is too early to get ready for ICD-10? Send your thoughts to Senior Editor Diana Manos at diana.manos@medtechpublishing.com.