The Centers for Medicare & Medicaid Services (CMS) released a final rule for replacing the 30-year-old ICD-9-CM code set with ICD-10-CM and ICD-10-PCS. The final rule outlines the the compliance date for as October 1, 2013 (four and one-half years from now).
ICD-10-CM includes five times more codes than the ICD-9-CM code set. The conversion will impact every aspect of business operations for physician practices and result in significant added costs. According to a recent study sponsored by several large medical associations and the MGMA, it will cost your practice about $28,000 per physician to convert to the ICD-10-CM coding system. According to the study:
- For a typical small practice, defined as three physicians and two impacted administrative staff , the estimated total cost impact of the ICD-10 mandate as $83,290.
- For a typical medium practice, defined as 10 providers, one full-time coder, and six impacted administrative staff, the estimated total cost impact of the ICD-10 mandate as $285,195.
- For a typical large practice, defined as 100 providers, with 64 coding staff comprised of 10 full-time coders and 54 impacted medical records staff , the total estimated cost impact of the ICD-10 mandate as more than $2.7 million.
These total cost estimates are based on an analysis of added costs in six key areas:
- Staff Education & Training Costs. will range from $2,405 for a small practice to $46,280 for a large practice.
- Business-Process Analysis of Health Plan Contracts, Coverage Determinations & Documentation. will range from $6,900 for a small practice to $48,000 for a large practice.
- Changes to Claim Form Software. will range from $2,985 for a small practice to $99,500 for a large practice.
- Computer System Changes. will range from $7,500 for a small practice to $100,000 for a large practice.
- Increased Documentation Costs. will range from $44,000 for a small practice to $1.785 million for a large practice.
- Cash Flow Disruption. will range from $19,500 for a typical small practice to $650,000 for a typical large practice.
Preparing for ICD-10
According to AHIMA, it would be impractical and a waste of resources and time to start training coders now on the specific updates to the code sets. AHIMA says coders should be trained much closer to the 2013 implementation date .
When the time comes, you can count on PMIC to provide the very best, innovative, high quality ICD-10-CM coding books, software and training materials. In the meantime, you can plan on continuing the use of ICD-9-CM for at least the next four and one-half years.