How to Estimate ICD-10 Transition Costs
The tenth revision of the International Statistical Classification of Diseases and Related
Health Problems (ICD-10) allows for the tracking of diseases and the sharing of
information between care providers, and contributes to the overall better health
worldwide. For hospitals, doctors, and all other medical care providers, the time to bring
your institution up to ICD-10 compliance is now.
The initial deadline to become compliant has already passed, but the government has
chosen to extend the deadline until October 1st, 2015. After that date passes, however,
non-compliant individuals and organizations could miss out on grants and benefits, or
face fines or other repercussions.
The initial cost associated with making the transition is what has stopped many of the
holdouts from attaining compliance, but while there will inevitably be some costs
associated with making the change, in the long run it’s a necessary and beneficial thing. It
is important to understand what to expect from the transition, and some factors to
consider that can help you begin estimating what it will take to get up to date.
Some major factors that can impact the cost of the transition are medical coding and
certification expenses, revenue cycle changes, and project management, IT, and other
extra staff costs. The new coding requirements will mean that certified, professional
coders will be in short supply. ICD-9 certified coders will have to receive ICD-10
training in order to understand the specific differences with the new edition.
There are many organizations, like LS Coding & Education, that can help find, train, or
retrain coders and consult with organizations about their coder options. During this
period, when many institutions are making the transition to ICD-10 compliance, there
will be a drop in coder productivity as they adapt to new regulations and procedures;
however, coder productivity and coder salaries should stabilize after 2015, once there has
been time for organizations to complete their transition and understand what the “new
normal” will be like.
There will also be an initial expense if an institution’s coding tools (encoders, abstracts,
etc.) have to be upgraded or replaced, but those are usually outdated pieces of equipment
that need or would soon need to be changed out, anyway. The IT department will be
significantly impacted during the install period for the new hardware and software,
dealing with any technical issues that arise during the transition and repairing all errors
caused by user mistakes due to inexperience with the ICD-10.
Physicians will also have to be trained to use the proper codes, and there may be a
learning period where errors increase due to improper coding, but these, too, should
return to pre-transition levels, with time. Additional hospital staff may be required during
the implementation process, especially in the areas of project management, training,
communications, public relations, risk management, and quality assessment, among
others.
While the enormity of the task may seem daunting, the transition to ICD-10 compliance
is a very manageable task. Most of the difficulty will come during a one to two month
period, as new processes and equipment are put in place and the necessary adjustments to
those changes are made. After that, business will settle back into a routine, and
organizations should not expect greater many more operating costs going forward. It is
better for patients, caregivers, and world health, in general, if providers make the change,
so be proactive and initiate the evolution, now, instead of waiting for the deadline to
force your hand.