Impact of ICD-10 in the Healthcare Community

Effective today, the ICD-10 Medical Coding system has been implemented in the healthcare industry. Over 68,000 new codes were added, to include more detailed specifics regarding diagnosis as well to include  multiple parts and systems of the body. With one exact code, not only your doctor but your healthcare provider can know exactly what your diagnosis is related to.

While the World Health Organization (WHO) had initially started working on ICD-10 in 1983, the updated code was not completed until 1992. The United States had initially had the implementation date set a year prior, however, due to certain setbacks, it has been pushed back twice. As a result of the setbacks, time was allotted for healthcare officials and administrations to create training for staff, and allow testing of new software to be completed. As a result, most companies implement new processes and procedures to ensure when the deadline hit, the transition would be smooth. However, most physicians offices had been lagging behind and were not prepared for the transition from ICD-9 to ICD-10.

Claims and billing processes tend to be of the highest concern for most dealing with the ICD-10 coding transition. With the fear of claims being denied for services rendered due to incorrect coding and poor documentation, most healthcare providers are concerned if they will be reimbursed.  Linda Girgis, M.D., a practice owner of Girgis Family Medicine in South River, N.J. notes "In order for everything to go smoothly, there has to be compatibility between the practices, clearinghouses, and insurance companies. So, I think we’re going to see some mapping errors where things don’t get transmitted correctly and there will be some corresponding delays." Many providers fear payment delays will interrupt their revenues and most doctor's are quite pessimistic about the new implementation. Dr. Jarrett Dodd, a physician at Central Virginia Family Physicians in Forest, said “The worst part of this for me is I think this is a waste of time." He continues "I think this whole thing is really not for the benefit of the patients; I don’t think it’s for the benefit of patient care. I don’t see where it’s gonna have significant enough impact in those areas to warrant how complicated this is."Dr. Thomas Eppes, who works with Dodd at Central Virginia Family Physicians, puts it more bluntly. “This could be a financial Armageddon to a lot of people,”

Still, most of the industry is waiting to see if the implementation will go smoothly or truly cause delays. While some insurance companies are understanding of such a monumental change, others are unwilling to accept errors. Medicare is giving providers a 12-month grace period, forgiving minor coding gaffes, yet no commercial provider has offered such leniency. 

While the healthcare industry has braced for this new code which has taken 11 years in the making, it is uncertain as to whether patient-centered focus will remain for physicians. Once thing is for certain, with the addition of a new coding system, all parties are having to learn a new methodology on medical codes. Dr. Marks, a former president of the Connecticut Orthopaedic Society, states “The number of codes is exploding. On Oct. 1, we will be speaking a new language. It’s like switching to German, after speaking English for 30 years.”