A year of ICD-10: Healthcare professionals weigh in

ICD-10 did not have the negative impact many industry stakeholders predicted. But coders' frenzied preparation for the Oct. 1, 2015 compliance date did have a silver lining for many healthcare organizations.

Cathy Brownfield, vice president of operations at coding audit and consulting firm TrustHCS; Debi Primeau, president and owner of health information advisory firm Primeau Consulting Group; and Mary Beth Haugen, president and CEO of healthcare consulting firm Haugen Consulting Group; shared their perspectives on ICD-10 a year after implementation.

Question: What was your greatest ICD-10 takeaway from the past year? 

Cathy Brownfield: One of the greatest takeaways is that preparation works! It was amazing to see how well our clients did when they put time and effort into ICD-10 preparation.

Debi Primeau: Interestingly, the implementation of ICD-10 was very smooth. I believe providers and payers really took the additional year to prepare, resulting in far fewer issues than had been predicted. As always, proper planning resulted in smoother implementation. Some industry stakeholders predicted decreased coding staff productivity would result in large days not final billed as well as force providers to contract with outside labor for coding assistance. This was not the case. Productivity was lower, but not to the degree predicted. I believe this was because many coding divisions began performing dual coding months prior to the compliance date.

Mary Beth Haugen: The preparation was worth the effort. Our clients that were diligent in their preparation for ICD-10 did not see a significant impact to their processes, systems or accounts receivable, like some organizations. Although many healthcare providers saw a decrease in coder productivity, the impact to A/R was not as significant as anticipated.

Q: Did you discover any silver linings from ICD-10 for your company or your clients? 

CB: We had a couple of silver linings. One is that we feel our coders have a better foundation of coding, particularly when it comes to anatomy and physiology coding practices. The second silver lining is that through our client training, we found a formula that really works well to train coders and clinical documentation specialists. We found the mentor model works exceptionally well.

DB: ICD-10 strengthened our project management skills. Those organizations who prepared, assessed new industry needs, identified mitigation plans and ensured their staff were properly trained were the most successful.

MH: A lot of the work that was done to prepare for ICD-10 is being used for other projects. It has been particularly helpful to those providers planning to undergo a system conversion. The preparation for ICD-10 provided organizations with an up-to-date listing of applications, versions, data flow, reports inventory and more.

Q: What do you expect going forward as CMS terminates its coding leniency policy Oct. 1?(Editor's note: CMS offered one year of leniency regarding detailed Medicare claims)

DB: I predict that those organizations who [still] have not conducted external coding and documentation audits will have some surprises. Hospital leaders can't afford to let sloppy coding practices slide, especially as Medicare will not accept unspecified codes [anymore]. I also expect more organizations will continue implementing computer-assisted coding tools. Organizations that have implemented [these tools] have seen improvement in some documentation areas, specifically in the outpatient areas.

MH: I feel payers are still in the discovery phase of ICD-10, and provider organizations will begin to see an increase in denials. ICD-10 is still new to some coders who haven't implemented best practices. If an organization has not been diligent in auditing coders and providing feedback, it may be at risk for an increase in denials. ICD-10 will undergo significant changes in October 2016, so coder education and auditing should be a priority for organizations. 

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