ICD 10 Mandate May Cost Small Practices Over $80,000

According to a new study, transitioning to ICD 10 codes will impact every aspect of business operations for physician practices

ICD 10 CostsWhile the rest of the world has been using ICD 10 codes for years, American doctors, hospitals, and health plan providers have been stubbornly plugging away using ICD 9, a code set last overhauled in the 1970s. The ICD 9 code set is not only outdated, it is also actually “full,” meaning there is no room for new codes to be added in an orderly fashion within the existing code format. Therefore the US is finally making the transition, with a mandated completion date of October 1, 2014.
While government agencies such as the Center for Medicare & Medicaid Services recommends beginning training no earlier than April, based on the idea that training should take 16 hours for physician practice coders and 50 hours for hospital coders who need to learn both diagnosis and inpatient coding. However, many private entities are skeptical of this estimate, considering that the new code set contains five times as many codes as the old one, and none of the codes are shared between the two sets.
At the request of the Medical Group Management Association and 10 other professional organizations, consulting firm Nachimson Advisors recently completed a study on the probable cost impact of transitioning to ICD 10 for individual provider practices. Here are some of the key findings from that study.

Total Cost Impact

The total cost impact of implementing the new ICD 10 code set is estimated to be $83,290 for a small practice consisting of three physicians and two medical records workers. For a large practice with 100 providers and 64 medical records workers, the cost could rise to over $2.7 million.

Six Key Areas of Impact

The transition to ICD 10 is expected to affect every aspect of business operations, including:

  • Staff Education& Training
  • Business Process Analysis & Coverage Determination
  • Claim Forms (Superbills)
  • IT Systems
  • Documentation Procedures
  • Cash Flow

Reduce the Burden with Help from HCC Coders

Contracting out your ICD 10 coding activities to HCC Coders can help reduce some of the burden presented by the transition. For example, all of our coders are already fully trained, which would save small practices an estimated $2,405 and large ones an estimated $46,280 on staff education and training. We can also help lower costs associated with software and documentation, because we have our own proprietary software for chart abstraction and coding activities. To learn more about how HCC Coders can help you navigate the transition to ICD 10, contact us today.