Meeting the Challenge of ICD-10

The switch to ICD-10 coming on October 1 is long overdue for the U.S. since other developed countries, like the United Kingdom, France, and Australia made the transition away from ICD-9 back in the 1990s.

ICD-10 was created to give physicians a more specific way of coding patient conditions. This is important since the nature of diagnoses and available treatments have changed dramatically in the decades since the inception of ICD-9. Still, some physicians are fearful the increase in specificity will lead to more claim denials.

But there’s no need to sound the alarm. Using ICD-10 will actually remove ambiguities and decrease the amount of supporting documentation needed to verify claims. Eventually, there should actually be fewer denials because it will be easier to assign codes correctly.

That’s not to say the transition will be easy.

Challenges of the Switch

ICD-9 has been in use for so long it’s become an integral part of our health system. The nation’s technical schools train and certify professional coders in ICD-9 and insurance companies have vast information systems built around the use of ICD-9.

Yet, small to mid-sized physician practices may feel the heaviest impact from the change. According to a study conducted by the American Medical Association in conjunction with a host of other national medical trade groups, the switch may cost as much as $84,000 for small practices and approximately $300,000 for practices with 10 physicians.

Most costs can be attributed to staff training, superbill revisions and cash flow disruptions. But the study also shows that renegotiating payer contracts, dealing with coverage determinations and increased documentation costs will be significant challenges to overcome, as well.

Meeting the Challenges

As the deadline draws ever closer, physicians are having to step up efforts to make sure ICD-10 doesn’t hurt their profitability.

Perhaps the most important step for practices will be aligning with a health IT vendor that will to make the shift from ICD-9 to ICD-10 a smooth one. Unfortunately, some vendors will try to take advantage of the situation and charge clients a fee for upgrades to the new coding set.

Cloud-based vendors, like CareCloud, provide the best option for ensuring a smooth transition. These companies have the ability to make universal and constant updates to their software, eliminating the need for clients to purchase and install update packages on a regular. Any necessary updates appear automatically on the system at no additional cost to the doctor.

Of course, a smooth transition will take more than quality health IT vendor. Physicians will have to study up as much as possible on the new regulations. Luckily, there are no shortages of guides and resources to help doctors with the move to ICD-10.

It will also take a fair amount of training. Providing periodic quizzes to coders, attending webinars focused on ICD-10 and gamifying the experience are just a few of the ways to get staff ready for the change.

Between now and October, it’s important that you prepare your practice for the ICD-10 switch and make the proper decisions that will prevent you from paying a steep price for the switch. While the initial stages of ICD-10 won’t be easy, planning ahead of time will make it far less painful.

See why CareCloud is the right vendor for your ICD-10 transition by contacting us at 1-877-342-7517 or

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