Meeting the needs of 21st Century Healthcare Providers

If you have heard about ICD-11 being released in May 2018, you may be wondering if it is worth the planning, time and expense, especially if you are still working the kinks out the current system’s processes and procedures. Considering the time it took to integrate the last system iteration, it may be too soon to worry adapting to a new framework.

When the requirements for ICD-10 were announced, there was an outcry that the changes would negatively impact all aspects of the billing process, from increased denials to coding compliance. Although the World Health Organization adopted the new system in 1992, it wasn’t a requirement in the U.S. for more than 20 years. The delay allowed the US time to see what worked and what didn’t in other countries. However, many providers have experienced marked improvements in their revenue cycle management.

Challenges of ICD-10

The new coding system has more than 68,000 diagnostic codes and 87,0000 procedure codes. Initially, finding personnel qualified to handle the heavier workload was the primary challenge. Other common issues included:

• Underestimating the work required to implement the new codes
• Modifying reimbursement rates
• Understanding how to meet compliance requirements
• Added complexity to accounting workflow

To combat the challenges, providers dedicated resources to support the transition in addition to in-depth coding training. In some cases, medical billing outsourcing was the most cost-effective way to maintain compliance. For providers who chose to keep operations in-house, medical billing consulting helped reduce the lag time and improve the learning curve.

Benefits of ICD-10

The next coding system reflects the needs of today’s medical professionals. It allows caregivers the ability assign detail and accuracy to complex or combined procedures. This enables comprehensive analytics for measuring safety and quality. The result is better patient care. Additional benefits include:

• Improved accommodation for continued advancements in medical techniques
• Better utilization of resources
• Reduced payer denial behavior
• Improved specificity
• Saving time and resources in the event of an audit
• Addressing healthcare reform initiatives

Meeting Digital Healthcare Needs with ICD-11

Advancements in technology since 1992 have changed the healthcare industry in some remarkable ways. ICD-11 has been in development since 2007 to help caregivers meet the need for increased detail and data. The goal is enabling it to function with electronic information systems and health applications, supporting electronic health records. Here are a few anticipated benefits of the new structure:

• Easier implementation as much of ICD-10 will be preserved
• Features and content from SNOMED CT will be incorporated.
• By linking ICD-11 with the Nomenclature of Medicine and Clinical Terms, a multi-dimensional database will replace current flat lists
• Four characters before the decimal point, instead of three, increases flexibility
• Unique specialties can be accommodated
• Several new chapters will be added

Although implementation of the new system may be a decade or more away, this may be a good time to begin exposing documentation staff and coders to the new classifications and framework.

At Rev-Ignition, we provide the tools and knowledge to help clients reduce costs and improve workflows. Whether you are still working to fully integrate ICD-10 or looking ahead to the next generation of advancements, we can tailor solutions that optimize your financial processes and maximize reimbursement for your services.