Health Insurance Accountability and Portability Act of 1966 (HIPAA) legislation has included a mandatory requirement for the use of ICD-10 with a compliance date of October 1, 2012 in the US. What this means is that over the next few years, all hospitals, doctors and health care providers would have to change the codes they use to identify diagnoses from the previously used ICD-9 to the new, improved ICD-10. A total of 138 countries have already adopted ICD-10 for mortality data purposes and 99 have adopted it for morbidity.
Although the use of ICD-10 as against ICD-9 spurs many advantages (improved healthcare quality, preventing frauds and more accurate representation of diagnoses, etc), the medical billing industry is still wary of the transition. According to the billing industry, the ICD-10 transition can have a negative effect on the current healthcare system if the transition is not properly planned. A preliminary estimate of the cost to the healthcare system would be anything in the range of $3.2 billion to $8 billion. The other aspect that worries them is the upgrading of their software systems to re-map the claim records of their patients.
Concerns of the Medical Billing Industry
The issues that concern the medical billing industry other than the cost impacts of the transition are the economic effects of the implementation. It is predicted that there will be a drop of 20%-50% in productivity during the ICD-10 transition. Here are some of the concerns of the medical billing industry:
– Accommodation of a greater number of diagnosis codes: One big area of concern is whether the current healthcare software systems would be able to accommodate the greater number of codes of the ICD-10 without any implementation hassles.
– Staff equipped to handle the transition: From the physicians to the clearing house meant for the payers, all would have to be proficient enough to handle the transition and not affect the productivity in any way.
– Greater costs: Another area of concern is the costs associated with the transition. Improper planning can significantly increase the cost of implementation drastically.
The ICD-10 transition is meant to be a welcome move, however it has the legs to become disruptive if proper planning and infrastructure is not taken into account before the implementation.
How Can the Medical Billing Industry Solve the Productivity Issues?
It is imperative that the medical billing industry follows a streamlined approach that can help prepare for the transition and also ensure that it isn’t at the cost of productivity. Some of the practices that the billing industry should follow include:
– Train your coding team: Healthcare providers should estimate the potential of their coding team beforehand. These figures can be used as the baseline for preparing the staff for ICD-10 coding and ensuring that they are well equipped to handle the transition.
– Use the latest technology: There are a number of tools that can help you perform your tasks faster and improve efficiency. Analyze your needs and use sophisticated instruments to aid the transition.
– Arrange regular training sessions and meetings: It is essential that you arrange regular trainings for your staff to educate them on the topic and highlight the scope of work for each one of them. Having regular meetings ensures that you track the progress made by the staff and also the team towards successful ICD-10 transition.
ICD-10 transition is inevitable and all the healthcare providers will have to modify their information systems to accommodate the codes not forgetting about the costs of implementation and training their staffs. Because of the number of systems and people involved in the transition, the costs are going to be substantial and the medical billing industry will have to understand that only knowledge and preparation can offer them a smooth solution.