ICD-10 changes could impact practice cash flow
Widely dubbed the Y2K of the coding world, last year’s conversion to the ICD-10 diagnostic coding system wasn’t nearly as expensive for practices as predicted. And reimbursements, thus far, haven’t declined as feared, physicians say.
“So far, we’ve had no issues with the transition,” says William Fox, MD, an internist in Charlottesville, Virginia. “There were many points along the process where things could have gone horribly awry,” he says, such as if the Centers for Medicare & Medicaid Services (CMS) had not been ready or if there had been serious software glitches with practice technology, like electronic health records (EHRs).
Coding could soon become more of an issue, however. Beginning October 1, nearly 2,000 updated codes will take effect when a long-standing code freeze expires. At the same time, a one-year grace period following the ICD-10 conversion ends.
During the grace period, Medicare Part B payers were required to waive specificity requirements as providers became familiar with the more detailed ICD-10 code set. The new codes are designed to create far more precise patient records that can be used to study population health trends and manage costs, among other goals.
After the specificity grace period ends, however, all bets are off.
“Payers now seem to be not complaining much about how claims are being coded. It’s unlikely that will remain the case,” says Ken Bradley, vice president of strategic planning and regulatory compliance for Navicure, a claims management and payment solutions provider in Duluth, Georgia.
So what are the financial lessons learned from the switch to ICD-10, if any?
Though it hasn’t been costly yet, many practitioners realize they’ll need to put more emphasis on collections in the future.