ICD-10 is coming

It’s coming — one of the most significant changes to the health care industry in recent history — and it isn’t the Affordable Care Act. The Centers for Medicare & Medicaid Services (CMS) is requiring all health care organizations to transition to ICD-10 coding and be able to fully process codes by Oct. 1.

So, what does this mean for Denver businesses?

According to a January 2014 report by the Metric Denver Economic Development Corporation, Denver and Northern Colorado make up a large health care cluster including more than 18,540 health care and wellness companies employing 182,320 workers.

Any health care or wellness company abiding by the Health Insurance Portability and Accountability Act (HIPAA) must implement ICD-10 coding by the deadline. Personnel affected by ICD-10 includes clinical and non-clinical employees:

  • Physicians, clinicians and nurses
  • Data managers, IT security and technology personnel
  • Quality and utilization management personnel
  • Research and ancillary personnel
  • Billing and accounting personnel
  • Compliance officers, auditors and fraud investigators

What is ICD-10?

ICD stands for the International Statistical Classification of Diseases. ICD is a global standardization tool for health conditions used by medical providers, health administrators, researchers and insurance companies. Currently, American health care organizations use ICD-9 coding, which includes about 14,000 classification codes. ICD-10 will include about 68,000 codes. This increase in codes will help better specify diseases and health conditions during diagnosis and processing.

If health care providers are not using ICD-10 codes after the Oct. 1 deadline, they increase the chance of their health claims being rejected by insurance companies, which can delay payment to the provider. This can have serious long-term financial repercussions, especially for smaller, independent medical practices.

ICD-10 and your practice.

ICD-10 implementation can be a daunting task for health care organizations because it requires IT upgrades, testing, assessment, and staff and physician training. This can result in a significant time and monetary investment for these companies. In order to reduce these investments, it is important to begin training and implementation as soon as possible.

Many health care companies believe that their current IT management company can facilitate the transition, or that they can train staff through distance learning programs, but this is not always the case. Every health care organization is different, therefore each should conduct research and choose the implementation program that is best for them.

Much of the health care community has done very little to prepare for the change, anticipating that the implementation deadline will be delayed, but ICD-10 is inevitable. This change will help create more efficiency in practices and improve overall patient care. Those who embrace the change will avoid practice disruptions and give their organization an edge above the competition.