Starting October 2015, medical facilities in the US will have to start using ICD-10 codes when submitting any medical claim. The International Statistical Classification of Diseases and Related Health Problems or ICD-10 is already used in a large part of the world. US, however, has until recently relied on the ICD-9 codes.
The ICD-9 code methodology came into existence nearly 30 years ago. In fact, the US is the only developed country in the world that still makes use of this outdated coding system.
The transition, however, is expected to have an impact on medical coders and the work that they do. What kind of impact is it going to be and will it change the medical coding workflow significantly?
The Differences between ICD-9 and ICD-10
There are significant differences between the ICD-9 and the ICD-10 systems, which is why medical coders may experience some problems in the very beginning. The number of codes used will go up. There were approximately 13,000 codes in the ICD-9 system. Under ICD-10, the number of codes is expected to reach 68,000.
In addition, the coding methodology itself is very different. The codes under ICD-10 could range anywhere between three and seven characters. The bigger number of codes and the variations in the code length enable more specificity for billing purposes but an adjustment period will certainly be needed.
Changes in the Coding Field
Hospitals and other medical facilities are expected to start hiring more individuals that have the proper training and the experience in the ICD-10 methodology. Thus, coders that have the certification will see an increase in the number of employment opportunities available.
The results of a survey conducted in 2014 suggest that 90 percent of the physicians are concerned about the introduction of the new coding system. Nearly 75 percent believe that their medical practice will be affected negatively by ICD-10.
Many doctors are expected to start outsourcing the medical documentation and coding process as a result of the change.
Since the risk of mistakes in the very beginning is high, many medical facilities will probably look for trained professionals that can handle the process. As a result, outsourcing will grow as a trend and medical coders will discover a vast range of new employment opportunities.
How will Professionals be affected by ICD-10?
It’s easy to see how these innovations will have a profound impact on the job of the medical coder.
The new system is expected to bring more transparency and accountability to the medical billing field. In the past, patients were at the mercy of many professionals (doctors, medical coders and insurance agency reps). The introduction of the new coding system comes with initiatives aimed at giving patients more information and boosting the overall transparency of the process.
Several apps have already been launched, enabling patients to understand what hides behind the code and to figure out what the cost of each procedure is going to be. Coders and other professionals in the medical field will have to take such factors in consideration when doing their job.
Challenges and Decreased Productivity?
For years, coders and medical billing professionals have dwelled in the security and the comfort provided by the relatively simple ICD-9 coding methodology. According to industry experts, the introduction of ICD-10 in the fall will certainly contribute to a major decrease in productivity.
Experts predict that hospitals and larger medical facilities could experience a drop in coder productivity ranging from 50 to 70 percent in the first months after the change. If coders have never practiced with the new system, they are expected to go through serious struggles.
In the past, the codes were standard. ICD-10 codes have to be built from the first to the last character. The coders need to have very strong interpretative skills, which were not needed in the field before. More in-depth reviews of medical documentation will be needed, which will ultimately contribute to even further decreased productivity.
There’s a recent example that demonstrates just how viable the prognosis is. Upon the introduction of the ICD-10 coding methodology in Canada, the coder productivity decreased by nearly 50 percent. The ICD-10 system introduced in the US is slightly more complex because it incorporates a procedure coding system (PCS) and the codes are also used for reimbursement purposes.
Only time will tell how the introduction of the new coding system will go. Just like any serious change, however, it’s expected to shake professionals up in the very beginning. The increased number of codes and the fact that they’re open to interpretation will probably be two of the biggest challenges.