ICD-10 Implementation Pros and Cons

August 22, 2014 Photos of a stethoscope, laptop, smartphone, and medical professional.

Implementation of the ICD-10 from the ICD-9 was delayed up to 6 times and was finally implemented on October 1, 2015. Many hospitals and practices feared that day, which has now come and gone. Those that think the conversion took place because of the ACA are deluded. True, ICD-10 was finally implemented due to the ACA, but the conversion has been in the works for several years. The ICD-9 was implemented in 1979, and several attempts have been blocked in the conversion, especially in the last 10 years.

So, are there advantages to the ICD-10 implementation?

Almost universally it is agreed, yes there are.

ICD-9 had 13,000 codes and ICD-10 currently has 68,000 codes and growing. The difference is as basic as being able to distinguish between a right and left limb in ICD-10 as opposed to ICD-9. Other advantages include: 19 times as many procedure codes, 5 times as many diagnostic codes, ICD-10 is alphanumerical rather than numerical, much greater specificity with the ICD-10, and room to add code sets for new procedures and new technologies to reflect the current medical practice in the USA.

So, what are the downsides?

It has been reported that it takes an experienced coder 69% longer on ICD-10 than ICD-9. 17 minutes vs. 5 minutes per coding. This can definitely slow down productivity. Will these increase reimbursements due to the lost time in coding?

It is understood the hospital owned practices and large group practices must hire trainers to come to the office and train for the conversion, not to mention the change of software needed to support the new codes. It’s important to remember this was going on during the depths of the recession! It is said nationally that anywhere from $2.52 billion to $10.5 billion was spent on the conversion. We think that is a very conservative number. It was an absolute boon for the IT companies that grew at alarming rates contracting software converters for both ICD-10 and the EMR systems. The companies that conducted the training also made a killing.

So what was the cost to a practice? For large groups anywhere from $25,000 to $3 million. For small practices; $5000 to $10,000. With the flexibility of more codes available and more detail, hopefully, this will balance out the investment. But with reimbursements dropping in almost every category, will it make any difference?

At first look, the conversion is a good thing and does have a quantifiable positive. Like so many trends and legislative battles that physicians get caught in the middle of; it doesn’t mean that it will positively affect your cash flow or profitability.

Good/Bad? You decide!