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evenue cycle management
The Not-So-Soft
‘Soft’ Impacts
of ICD-10
The time to baseline processes is now.
By Patrick McNeese
Now that the decision on the ICD-10 compliance date has
been announced, it’s a good time to take a step back from
mapping, translating and evaluating codes and look at some
of the so-called “soft” impacts associated with the ICD-10 transformation.
Prepare for Productivity Loss
Loss of productivity for virtually everyone engaged in using the
new code sets is viewed as one of the “soft” impacts that may be
difficult to measure empirically, but will undoubtedly translate into
significant financial shortfalls for many organizations.
In 1999, Australia transited to ICD-10 and experienced a
productivity loss higher than 25 percent that did not return to
pre-transition levels for more than a year. Canada experienced
increased productivity losses following their transition in 2004
and never returned to pre-transition levels. I am not a seer or
an expert but the general consensus is that the U.S healthcare
space will experience similar productivity losses exacerbated by
being the first nation to incorporate ICD-10 into reimbursement
methodologies.
An overall loss of more than 25 percent that extends beyond a
year does not sound “soft” to me at all; rather it appears as be a proverbial
ICD-10 “elephant in the room” that needs to be addressed.
Organizations should be baselining processes now. ICD-10 impacts
may be completed and the productivity warnings issued.
Understand the operational areas where productivity may be most
impacted and measure current productivity levels. How long does
it take for an experienced coder to complete a claim submission
on a simple procedure? How long for an inpatient stay?
Remember that the simplest claim submission under ICD-
10 looks like a medium complexity submissions in ICD-9. As
painful as it is to think about that, there will be
more than 300 ways to code a diabetes claim.
How long does it take for a talented claims examiner
to evaluate a simple suspended claim?
Patrick McNeese is business solution manager and
ICD-10 practice lead, DST Health Solutions LLC.
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