As healthcare organizations prepare for the ICD-10 changeover on Oct. 1, there are concerns arising about harmful impacts, which are sometimes overstated. The first is fear that there will be productivity loss due to the complexity and size of ICD-10. Challenges faced by American coders could be mitigated by strong ICD-10 training and clinical documentation improvement programs. In addition, medical practices should look for ways to streamline workflow for medical coding, remove inefficiencies and add automation. Another concern about ICD-10 is that denial rates will shoot up, the American Medical Association is predicting denial and rejection rates as high as 20%, which is their reason for proposing an ICD-10 grace period. Before medical practices panic over a potential increase in denied claims, medical practices need to understand what triggers denials now and what could cause problems with ICD-10 claims. Comparing these denial statistics will help prevent crippling reimbursement delays.
One more big concern is that the number of queries from medical coding staff will increase if physicians aren’t documenting at a level that supports ICD-10 specificity. Medical coders will for example need to write in concise ICD-10 language and use evidence specific to each case. Medical practices need to continue to increase productivity even after Oct. 1 in order to make ICD-10 as efficient as possible. This will be accomplished through better training for coders, starting ICD-10 denial management now, and maintaining highly efficient query documentation.
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Alison Killian is a recent graduate of Grove City College who majored in Business Management and minored in Biology Studies. She is a contributor to Medical Groups and passionate about all facets of healthcare. She plans on continuing work in the healthcare field especially in management. She is very interested in healthcare innovation and finding ways to improve the current system. She hopes to go back to school in a few years to earn a degree in medicine.