I don’t know about you, but when I think of the year 2015, the first thing (or code set) that comes to mind is “ICD-10”. This new, more-specific coding system to document patient visits was finally implemented instead of being pushed to 2016.
You’ll recall there was lots of concern with the implementation of this new coding set. Industry experts were predicting gloom and doom resulting from practices experiencing an increase in coding errors, denials, and a decrease in productivity.
Yet, your practice stoically faced this doom and gloom and overcame it…for the most part. It would be wonderful to say the industry, as a whole, made it through the ICD-10 transition unscathed. But that simply isn’t true. Transitions are never easy and often leave several points of struggle in their aftermath. Let’s review potential struggling points in the three areas I mentioned:
- Coding errors – I think it’s safe to say all practices have experienced an increase in coding errors. When moving from a code set in use for over 35 years, there will be errors. Thanks to ICD-10 crosswalks, reference guides, online code searches, and tools EHR providers built into their systems (to name a few) the number of coding errors didn’t live up to the expectations of the doomsday prognosticators.
- Claim denials – Claim denials were expected to rise as well, resulting from the ICD-10 transition. Doomsday advocates painted a picture of denials skyrocketing and private practices struggling to make ends meet. The reality is, while there has been a slight uptick in denials, it hasn’t been anywhere close to the levels advertised. One of the more common scenarios private practices are seeing is carriers letting the window to rule on claims pass. Once the window has closed, the carrier waits for the practice to follow up with the claim before taking any action. There was also a situation where CMS didn’t update edits, causing an uptick in claim denials as well.
- Decrease in productivity – Again, this was to be expected as a side effect of transitioning to a new code set. While your staff won’t be able to process as many claims as they were using the ICD-9 code set, their productivity levels will return with time. It all boils down to how long it takes them to become way too familiar with the ICD-10 codes. So, you should see productivity levels return within a few months of the transition.
I think a better way of describing the ICD-10 transition, is while it wasn’t as painful as industry experts lead us to believe, it left rough spots needing to be smoothed over. Luckily for you, we’ve identified these rough spots through conversations with our clients and industry research. Join us on March 17 as we give you solutions to the most common post ICD-10 transition problems practices like yours encounter daily.