Effects of ICD 10 Delays in Medical Billing Services

June 16, 2014

Delay in ICD 10 transition to 2015 has many unprepared medical practitioners heave a sigh of relief and gave reasons for silent groans from the prepared ones. While some had been heavily investing on preparations of ICD 10 transition, others were still trying to grasp the proportions of change that the code brought about. The delay will still have both, positive and negative effects of the ICD 10 coding change on both the practitioners. The probability of a new super bill being launched in place of the planned ICD 10 coding guidelines is posing to be troublesome for those medical practitioners who have spent thousands of dollars on preparation for the coding change. Following effects of the ICD 10 delay can be seen in the healthcare industry in the months to come -

  • Large hospitals and medical practitioners who have invested heavily in adopting coding changes and have outsourced billing services functions for smooth transition from ICD 9 to ICD 10 in October 2014 are bound to take the litigation route in order to recover their investments.
  • As the Sustainable Growth Rate (SGR) formula cuts were also impending with ICD 10 launch, medical practices have been keeping funds aside for financially viability. This is a fallback measure taken by practitioners should an untoward event of unwarranted reimbursement cuts happen due to coding changes and SGR cuts. This has affected the overall profitability and short term financial planning of many hospitals and independent care providers. With ICD 10 getting delayed by another year and SGR still remaining a confusing concept, medical practitioners are likely to rethink their preservation and precaution plans for transition to the same.
  • Patients were also likely to benefit in the event of ICD 10 coding launch as there was potential for lesser coding errors, better claims settlements and shorter processing times. It could have easily been a win-win for all stakeholders including insurance carriers, patients and medical care providers. This delay in ICD 10 transition is going to change the entire perception and approach of concerned parties towards healthcare regulations.
  • From a macro-sectorial point of view, ICD 10 delays can place the US healthcare system below many other healthcare leaders in the world. With coding changes pending at the most basic granular level, complicated SGR and the delay of these transitions, US healthcare industry may start crumbling under the politics and bureaucracy of coding rather than its operational excellence.
  • Even from the point of view of healthcare vendors and insurance carriers this ICD 10 delay may be a last straw for their patience. Where most clearinghouses and insurance carriers depend on Medicare, Medicaid and other government regulations on coding to define their reimbursement rates, ICD 10 transition was going to be a major event. The delay in coding change can escalate claims rejection rates in times to come as medical practitioners are bound to be more confused with yet another format of ICD 10.

MedicalBillersandCoders.com is a billing service provider which can help your medical practice cope with this undue ICD 10 delay and prepare for the upcoming super bill in healthcare. Our teams of medical experts and consultants specialize in ICD 9 to ICD 10 transitions and can transform your practice in both, operational and financial aspects by the time ICD 10 will actually be launched.


Category : Practice Administration