With ongoing debates about the transition to ICD-10, the results of the end-to-end testing offered by the Centers for Medicare and Medicaid Services (CMS) should be telling. In fact, two of the testing sessions are already in the books, having been completed in January and April of 2015. The last session is slated for this July. CMS says the goal of this testing is to demonstrate that providers are able to successfully submit claims using the new codes, that software changes made to support ICD-10 are resulting in appropriately adjudicated claims, and that accurate RAs are being produced. Approximately 2,550 volunteer submitters (providers) are supposed to be participating.1
As you may be aware, the compliance date for the new ICD-10 system is October 1, 2015. This deadline is actually the second one, having been moved back from last year partially because of so much pushback by the physician community, which has been generally characterized as being against implementing ICD-10-CM/PCS.2
Brian Anderson, MD, a contributor to KevinMD.com, had this to say about the transition to ICD-10. “This will be a painful process and could potentially have a negative effect on clinical decision-making and patient care. That concerns me deeply. Simply put, providers don’t want to create unnecessary systems of documentation that mean more clicks, burdensome workflows and highly detailed use of the new code set if they don’t absolutely need to.3”
“The new system means less modifiers on CPT codes because the diagnosis codes are more specific.”
There are conflicting studies concerning the actual cost of transition for small practices. The numbers range from $250,000 to just $8,000, depending on the study.4
However, there is another side to this debate. “John Hughes, M.D. Professor of Medicine at the Yale School of Medicine, said that ICD-10 will accurately describe information on procedures that will ultimately lead to new discoveries and treatments. Sue Bowman, the senior director of coding policy and compliance for the American Health Information Management Association (AHIMA), listed the many improvements that will come from ICD-10 including analysis, ability to measure outcomes, public health measures, and much more.4”
The Senate Finance Committee Chairman Orrin Hatch (R-Utah) seems to agree, recently going on record as saying, “While additional testing will be needed to ensure its success, the transition to the new system will streamline the management of healthcare records and improve patient care.5”
If the industry workload increases significantly to implement this transition, and if the new system sustains a continued increased demand for labor to process the same information as before, this could translate into a significant increase in the need for billers and coders across the healthcare industry.
Lisa Riggs, CPC Instructor at Ultimate Medical Academy, summarized her point of view on ICD-10 this way. “The new system means less modifiers on CPT codes because the diagnosis codes are more specific. We’re working on ICD-10 coursework for Medical Billing and Coding at UMA right now. It’s coming soon.”
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