Though it's still on the horizon, the anticipated change from the current 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 to purchase new software and perhaps new computer systems. They'll also need time to map from one coding system to another and provide training, 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 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 within the next few weeks, and it could be as early as October 2010, Bernard said.
Providers should set up a committee now to plan the transition and include stakeholders, finance and coding departments and clinicians, Bernard said. They should also assign a leader responsible for the organization's overall 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 document their work more extensively or risk losing reimbursement under ICD-10.
Grider, who conducts training sessions 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 have 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. They take the `let's just wait' attitude."
Grider said coders should talk now with their employers to analyze how to handle the potential costs and set up a timeline for getting ready.
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.