March 15, 2017

18 Months On: Learning the Real Impact of ICD-10 on Hospital Revenue Cycle Management

image 1: The Real Influence of ICD-10 on Hospital Revenue Cycle Management

The introduction of ICD-10 as a new classification system sparked controversy in the healthcare community. ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems issued by the World Health Organization.

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There were many predictions that the hospital revenue cycle management process would be severely affected, as the coding system increased diagnostic codes to over 68,000- up from just 14,000. Procedure codes had a similar story, rising from 4,000 to 87,000.

It’s now been 18 months since the ICD-10 system was implemented in America. What has the real impact of this change been and was it as bleak as was expected?

Falling Productivity Levels?

It was expected that productivity levels would drop by around 50%, causing far more hold ups and errors than ICD-9 had done. This was based on Canada’s results back in 2001, which found the amount of work required to input each code had been underestimated.

In reality, the U.S. healthcare system has managed to cope with the change very well and productivity levels only dropped by about 25%. As America transitioned much later than other countries, it focused on training and preparing its coders as well as possible, as well as involving health information management (HIM) staff and physicians in this training.

Consequently, hospitals were well prepared once ICD-10 came into effect. There were small increases in Discharged Not Final Billed (DNFB) numbers and errors, though not as many as were thought to happen.

18 months on, productivity levels seem to have stabilized at a 10-15% lower level, compared to the period before ICD-10 was introduced. This may not sound like much, but this could mean each coder fills out two to four fewer inpatient charts on average each day. For hospitals who want to streamline their process, it’s recommended that they use a company skilled in this area to keep revenue cycle management processes as straightforward as possible.

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New Diagnostic Codes

Although ICD-10 has now been fully implemented, hospitals cannot sit back and relax. For 2017, expect an additional 1,900 diagnostic codes, and 3,651 inpatient procedure codes to be implemented. Not only will additional training be required, but processes will need to continue to be streamlined so that fewer fiscal and financial errors are made by coders.

If your hospital’s revenue cycle management process is not improved, it could cause payers to erroneously deny patient claims or at least ask for additional information and hold up the process. There’s no cause for worry, as there are companies skilled in cycle management processes who can assist your healthcare facility based on the last 18 months of ICD-10 implementation evidence.

Constant evolution in procedures and legislation don’t have to cause issues in your facility. Contact experts in eligibility to begin vital changes to your hospital’s revenue management processes that also improves patient experience.

About DECO: If your hospital needs support to review and better your current revenue cycle management processes as a result of the many recent healthcare reforms and changes, we at DECO can help. We are experts in eligibility management especially in the qualifying and processing of Medicaid social security disability insurance claims.

Sources: A Year Later: ICD-10’s Impact on Revenue Cycle Management, Health-SystemManagement.AdvanceWeb.com 5 Most Common Hospital Revenue Cycle Management Challenges, RevCycleIntelligence.com

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