What to Expect: The ICD-10 Transition

With the transition to ICD-10 just a day away, many healthcare providers are preparing for the worst. Claim denials could double while providers familiarize themselves with the expansive codes.

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The switch will take place on October 1. Many providers are expecting problems due to the expansive nature of ICD-10.

The new system is much more specific and detailed than ICD-9. For example, under ICD-10:

  • Cardiologists no longer have 1 code for angioplasty, now they have 845 codes;
  • Dermatologists need to specify which of the 8 kinds of acne a patient has;
  • External causes of injuries have been greatly expanded;
  • Overall codes are expanding from 14,000 to 70,000; and
  • Hospital specific procedure codes are expanding from 4,000 to 72,000.

Although many providers are concerned about the daunting transition, a lot of experts feel that the transition is necessary to better identify public health issues and to manage diseases.

So what is the cost of the transition?

The costs have varied from practice to practice. The range is anywhere from $10,000 to $225,000 for small practices.

Some hospital systems have spent millions of dollars.

The cost has come through training programs, applications, practice drills and other preparations for the transition.

Although we know the transition is sure to seem overwhelming, remember that Medicare officials won’t deny claims for lack of specificity for the first year.

But be warned – the grace period doesn’t apply to hospital procedure codes or most commercial insurers.

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