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Healthcare Practice Strategies - Spring 2014 - Life After ICD-10

May 27, 2014

Most people don't like change. And the switch to ICD-10 is about as big as change gets for practices. The new code set includes five times as many codes, and the different coding arrangements will certainly require more precise and thorough documentation.

In fact, a study commissioned by The American Academy of Orthopaedic Surgeons projects that the move to ICD-10 will increase documentation activities by about 15 to 20 percent. This translates into a permanent increase of 3 to 4 percent of physician time spent on documentation.

That said, the new code set does offer real value to physicians who leverage it correctly.

  • Potential for increased compensation and reimbursement – ICD-10 provides more diagnostic choices, and the codes carry much more descriptive information. In particular, the new code set offers a better way of documenting "severity of illness." Physicians can use ICD-10 to make sure that charts reflect how sick patients really are. By providing greater detail on the severity of the illness and the quality of the care they provide, physicians can help ensure that they are fairly compensated for the complex work they perform.

  • Faster payment – The specific codes of ICD-10 may also simplify prior authorizations or eliminate the need for an appeal, saving valuable physician and staff time while reducing payment delays. Ultimately, ICD-10 may encourage payers to cover more procedures, pay faster and reimburse more accurately.

  • Audit protection – Using the more precise ICD-10 codes, physicians can paint a much clearer clinical picture with their documentation. This can help ward off a Recovery Audit Con-tractor audit and reduce the chance of misinterpretation by third parties, auditors and attorneys.

Healthcare Practice Strategies - Spring 2014

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