Pressure from the American Medical Association and other groups caused The Centers for Medicare and Medicaid Services (CMS) to delay implementation of ICD-10 to October 1st, 2014. ICD-10 started in 1993, and is in use by most every other country around the world except the United States. ICD-9, the current system, got started in the 1970’s.

Why are practices apprehensive about the move to ICD-10? ICD-10 has many more codes. Compared with the 17,000 in ICD-9, ICD-10-CM which will be used in ambulatory settings, has 68,000 codes. ICD-10 codes offer more detail in describing a diagnosis and may communicate the particular manifestation or location of a disease or injury.

First and foremost, practices are concerned that moving to ICD-10 will overly complicate their billing process. They are rightly concerned; physicians will have to familiarize themselves with a new set of codes. Billing professionals will need to check the physician’s work and post charges to the billing system. Practices may need to upgrade or change billing systems to support the new codes. In addition, private insurances may not all accept ICD-10 by the deadline, so practices may have to report ICD-9 and ten simultaneously.

All of these extra steps slows down workflow, which means practices may have to decrease patient volumes during the transition period. Decreasing volumes mean declining revenue. Combine revenue loss with the need to purchase a new practice management or billing system and it spells financial trouble.

While the decision to purchase Electronic Health Records (EHR) and participate in the HITECH Stimulus program, also known as meaningful use, is mostly voluntary, switching to ICD-10 is mandatory. Practices still using paper records will experience the most difficulty switching, as their current one-page super bills will balloon to eleven or twelve pages under ICD-10.

If your practice is postponing EHR implementation, or considering foregoing it altogether, you should think again. ICD-10 will likely be the final death knell for paper record keeping. Although two years until the deadline may seem like a long time, it really is not, considering the lengthy EHR implementation process.

Many practices take between six months and a year to select an EHR. Depending on the system, the full implementation may take another six months before every user is up to speed and comfortable with the system. Combine that with the necessity to change practice management systems and learn new billing codes, and two years is much time. Does your practice have an ICD-10 implementation strategy? We would love to hear from you; please contact us at info@xlemr.com for more information.