Even for physician specialists or specialized healthcare facilities that generally handle a smaller number of different claims codes, the ICD-10 transition has the potential to have far-reaching, disruptive consequences, according to a study in the Journal of Oncology Practice.
Researchers from the University of Illinois at Chicago studied coding ambiguities using the subset of hematology and oncology diagnoses to predict the challenges and consequences of the switch for all providers. Researchers selected 120 ICD-9 codes with the highest Medicaid reimbursements among hematology/oncology physicians, and 100 of the University of Illinois Cancer Center's most-used ICD-9 codes. Researchers then translated the codes into ICD-10 codes and analyzed whether a loss of information occurred in the translation and whether that information loss would have financial consequences for the provider.
"What we found was the transition from ICD-9 to ICD-10 led to significant information loss, affecting about 8 percent of the Medicaid codes and 1 percent of the codes in our cancer clinic," said Neeta Venepalli, MD, UIC assistant professor of hematology/oncology and the study's lead author, in a news release.
In terms of financial implications, the researchers found the 39 ICD-9 codes where information was lost in the translation accounted for 2.9 percent of total Medicaid reimbursements and 5.3 percent of the clinic's billing changes. Researchers concluded the transition could have a very real impact on providers' finances.
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