Could ICD-10 Implementation Cause Reimbursement Problems for Physicians?

Healthcare Consulting Services, Dallas, Fort Worth, TexasHealthcare executives throughout the nation are carefully following along with all of the most recent news about ICD-10 implementation and the delays that have accompanied it. Many reports seem to indicate the industry is not fully prepared for implementation, and that there is still a lot of confusion about what exactly using ICD-10 will look like.

The biggest challenge physicians will have to face with ICD-10 by the time it is supposed to be implemented in October is documentation, as well as the kind of impact it will have on reimbursement. For the most part, physicians will be able to continue performing their jobs in the same way. The challenge is going to be getting them to adhere to completely different standards of specificity in reimbursement documentation. Treatments will get billed and coded in new ways, which means there will likely be an adjustment period for healthcare professionals.

If the physician fails to properly document the treatment, then it won’t be correctly coded. And if the treatment isn’t correctly coded, there is a chance the physician and health care system will not get the reimbursement or cash flow they need.

This is why so many physicians are reluctant to transfer to ICD-10, and why physician organizations have fought its implementation for so long. It’s extra work for these physicians to ensure the accuracy and thoroughness of their documents, and failure to perform that extra work could cause some serious reimbursement problems.

This makes the transition to ICD-10 a rather risky endeavor. Many physicians might wonder what’s in it for them to spend more time and effort on documentation and simply not bother. Others might actually make a serious effort to follow the new guidelines, but fail at figuring out how to meet the new standards for documentation.

But despite the delays in ICD-10 implementation, it’s clear that it’s going to inevitably happen sooner than later. In the meantime, it is up to physicians and health care systems to get prepared to avoid any problematic issues arising in terms of reimbursement.

About Howell Consulting Group

Howell Consulting Group provides healthcare consulting services to hospital and physcian practices nationwide. Our key focus areas are revenue cycle management, health information technology, and revenue cycle billing and collections.

HCGs consultants are highly experienced in all aspects of healthcare financial management. We implement revenue cycle best practices to optimize your receivables performance and maximize your cash flow.

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