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3 Ways Delaying ICD-10 Transition Will Cost Your Practice

April 9, 2013

delaying icd 10 transition resized 600Many practices are putting off the transition to ICD-10 as long as possible, and you may be one of them. This is understandable, since the transition is going to take a lot of time, effort and resources. The most time-consuming aspect of the transition is the extensive training that it is going to take to make sure the complete medical team is up-to-date with the new codes. The switch is mandatory, but since it is not required to be completed until October 2014, it would seem logical to wait as long as possible to complete the switch. However, delaying the transition to ICD-10 may actually cost your practice valuable money in the long run. Here are three reasons you should not delay the transition any longer.

More Accurate Reimbursement

According to the American Medical Association, the ICD-9 that you are currently using has been around since 1978. Think about how much has changed since then. Think about how many medical advances have occurred. ICD-9 only has a limited amount of codes that can be added thanks to its numerical formatting. That means that some diagnoses have to just be placed wherever they fit the best. What that means for you is that you may be getting underpaid. With ICD-10, the codes use both numerical and alpha characters, so there is a lot more combinations that can be used, making diagnoses much more accurate.

Faster Claims Processing

Not only can you get more accurate payment for your work, you will also be able to get the money faster. Since ICD-9 is so out of date, a lot of claims cannot be processed automatically. According to Medscape, it is not because anything is wrong with your work; it is because the coding does not accurately fit the description of your diagnosis. So what happens? The insurance company has to wait around for a manual review, which takes time. With ICD-10, the codes allow for much more accuracy and detail, so there is a lot less of a chance that your claims will get suspended. Faster claims processing means you get the money a lot faster.

Fewer Rejected Claims

Once again, there is a lot of room for error with ICD-9. It was created so long ago there is just not an accurate code for everything that you do in your practice. For this reason, many claims get rejected. When a claim gets rejected, you have to trust that the patient will pay you the money you are owed. While this may happen on a timely basis, chances are you will not get paid the full amount you are owed. They will either try to negotiate the price with you or not pay it at all. However, ICD-10 is setup to allow you to code every claim with precision. When you can code a claim according to the exact diagnosis, it will be processed the way it should be and you will get paid.

Yes, the transition to ICD-10 is going to take a valiant effort on your part. It is not an easy process, but it is one that must be done. Since you are going to have to invest the time and money for the transition eventually, you may as well do it sooner than later. It’s not like delaying the inevitable will save you from having to put in the work it takes to implement the new system. Every day that you are not using ICD-10 could be costing you and your practice a substantial amount of money; money that you will never be able to get back.



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