Issue link: https://beckershealthcare.uberflip.com/i/548475
47 Coding & Billing O n Oct. 1, the U.S. Centers for Medicare and Medicaid Services will require all Health Insurance Portability and Accountability Act- compliant healthcare providers to transition to the 10th version of the International Classification of Diseases. The first update to the coding systems in more than three decades, ICD-10 includes 68,000 codes — rough- ly 50,000 more than its predecessor — and has been adopted by more than two dozen countries around the globe. Whether or not to implement ICD-10 here in the United States has been the subject of a lively public discourse. Its champions argue that ICD-10's enhanced granularity will be a boon for public health; its detractors claim it's a costly transition at a time when the U.S. healthcare system is already undergoing tremendous upheaval. To be sure, there's no shortage of passionate voices on either side of the ICD- 10 debate. What's also certain is that ICD-10 implementation poses serious operational and financial challenges for ASCs and other specialized facilities that typically have less access to resources than hospitals and other large pro- viders. And with the deadline now less than three months away, another delay seems less and less likely with each passing day. Support staff productivity is expected to plummet after Oct. 1 — and the reality could be far worse than widely published industry reports suggest. According to a recent time study published in the journal Perspectives in Health Information Management, "The prevailing estimate of produc- tivity loss is typically somewhere between 30 and 50 percent. However, preliminary results of this time study overall were much higher, with ICD-10-CM/PCS coding taking 69 percent longer overall and, at best, 54.4 percent longer when performed by the participants with the most training in ICD-10-CM/PCS." As a result, cash flow is expected to be a direct casualty of a post-Oct. 1 drop in productivity. Unfortunately, many providers appear unaware of this con- nection. In 2014, KPMG published a survey indicating that roughly half of the physicians interviewed had not assessed exactly how ICD-10 implemen- tation could disrupt their practice's cash flow. That's a potentially dangerous oversight, as the Healthcare Information and Management Systems Society has recommended that healthcare practices have at least six months of cash flow on hand to safely get through the transition. A 2014 American Medical Association-commissioned report also estimates that ICD-10-related cash flow disruptions will cost practices between $19,500 and $650,000, depending on the size. Other costs, too, will add to a practice's final ICD-10 price tag, including additional documentation costs ($44,000 to $1.79 million), information technology ($7,500 to $100,000) and process analysis expenses ($6,900 to $48,000). Are You Ready? Productivity, Cash Flow to be Hardest Hit by ICD-10 By Jessica Edmiston, National Medical Billing Services, senior vice president, performance review, BS, CPC, CASCC, AHIMA-approved ICD-10-CM trainer ANTICIPATE CHANGE. WE DO. 636.273.6711 | www.nationalASCbilling.com The ASC Revenue Cycle. It's all we do. It's all we think about. And it shows. Hospital Review 150 Great Places to Work in Healthcare 2015