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ICD-10: How It Will Impact Physicians

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stethoscope-on-keyboardSince 1979, American physicians have relied on the same system to code diagnoses: the International Classification of Diseases version 9 (ICD-9). While most other nations transitioned to ICD-10 years ago, the U.S. Department of Health and Human Services has lagged behind. That is, until now.

October 1, 2015 is the deadline for which all HIPPA-covered entities are expected to switch their systems over from ICD-9 to ICD-10. Being that this shift is so large—with ICD-10 having more than five times as many codes as ICD-9—practices are expecting more documentation, revised forms, retraining of staff and physicians and changes to software and other information technology. In other words, the impact of this transition is going to be significant.

Here is a closer look at how the move will specifically impact physicians:

Implementation Costs

In addition to implementing the new ICD-10 code sets, practices will have to implement the next generation version of the nine HIPAA electronic transaction standards (5010). In fact, this must be completely done prior to the adoption of ICD-10, for the ICD-10 code set cannot operate with the current HIPAA transaction standards (4010). This implementation will come with many costs to physicians, such as staff education, coverage determinations, changes in health plan contracts and superbills, IT system changes and possible cash flow disruption. The billing services and clearinghouse vendors practices use will likewise have to comply with the new changes.

As far as total implementation cost, various healthcare organizations have conducted studies which estimate the cost of ICD-10 code set implementation to be as much as $83,290 for a 3-physician practice and $2.7 million for a 100-physician practice.

Documentation Costs

Documentation is where the costs hit the hardest. According to the study (linked above), implementing ICD-10 will permanently increase documentation activities somewhere between 15 to 20%. Being a permanent increase and not simply an implementation or learning curve increase, this translates into a permanent increase of 3 to 4% of physician time spent on documentation. So essentially this is a physician workload increase with no expected increase in payment.

This additional time spent working is a consequence of the increased requirements for providing specific information for coding. Unfortunately, electronic health record systems won’t be able to eliminate the extra amount of time required.

Of course a change this substantial will require time, likely resulting in a lengthy transition period. If you need more information on how to make the transition as seamless as possible, feel free to contact us today.