How ICD-10 has Impacted Healthcare

The World Health Organization established the International Classification of Diseases (ICD) to standardize medical records. ICD-10 is an update that reflects changing needs in the medical field. The code has provided increased detail and flexibility over the last ten years. However, implementing the code presents medical establishments with several challenges. The biggest challenge is finding qualified personnel to handle the increased workload created by the transition.

How ICD-10 Impacted Healthcare over the Last Decade
Over the last ten years, the ICD-10 framework has allowed caregiving institutions to increase reporting details using fewer codes. [1] The system now reflects contemporary medical practices and also allows caregivers to notate complex combined procedures with detail and accuracy. Additionally, ICD-10 coding follows a common theme across the entire framework, streamlining workflow compared to ICD-9 codes. Most importantly, ICD-10 has kept pace with changes over the last ten years, a feature overlooked in ICD-9 development. As time goes on, ICD-10 will continue to facilitate improvements in caregiving operations. These five areas affect how caregivers process patient information.

One: A New Identification Scheme
A report authored by the American Medical Association outlines the differences between ICD–9 and ICD-10, such as the addition of two characters and more alpha characters that increase the available classifications from 13,000 to around 68,000 codes. [2] The framework provides more classification flexibility and allows caregivers to provide more accurate service information.

Two: Increased Coding Workload
Caregiving facilities suffered from coding personnel shortages well before the ICD-10 transition. [3] The medical community’s almost four-decade reliance on ICD-9 resulted in a minimally supported coding education environment. Upon ICD-10 implementation, many organizations had no other choice but to rely on offshore coding services. Due to the update, the Bureau of Labor Statistics forecasts an almost 40,000 coding job opening increase between 2010 and 2020. To date, many organizations still struggle to procure coding personnel. Adding to the problem is that many veteran coders choose retirement over learning the new framework. Because of these complications, federal legislators extended the deadline for healthcare organizations to adopt ICD-10 by one year.

Three: New Challenges and Opportunities
ICD-10 is the most monumental coding change in almost 40 years. [4] While many organizations and administrators perceive the framework’s long-term benefits, they have come to realize the transition to the new standard is a challenge. Despite this inconvenience, caregiving institutions recognize that ICD-9 no longer supports contemporary medical operations. On a positive note, the ICD-10 coding framework arrives at the perfect time for healthcare providers to exploit the detailed information using big data analytics. These two developments will drive service delivery improvements by improving provider collaboration, community wellness and doctor-patient relationships.

Four: A More Complex Accounting Workflow
The new framework permeates throughout the entire medical practice revenue cycle. In a relatively short time span, ICD-10 has reduced many issues involving care provider procedure recording and reimbursement. A report authored by Alexa Arends-Marquez, et al. on the American Health Information Management Association (AHIMA) website forecasts that ICD-10 implementation will initially slow processing. [5] Caregiving facilities will experience backlogs in information processing such as:

  • Scheduling
  • Pre-certification
  • Pre-registration
  • Estimates
  • Registration
  • Case Management

Caregivers will have to educate staff members and patients on adapting to the new system and providing or obtaining the right information to complete processing. Additionally, caregiving facilities will have to revise their procedures to accommodate the new system. The ICD-10 system will affect caregiving finance departments’ ability to perform billing, collections and reimbursement operations. Billing includes processes such as:

  • Late charges
  • Electronic data interchange (EDI)
  • Discharged not final billed (DNFB) accounts
  • Transaction code frameworks

Collections and reimbursement processes that ICD-10 may affect are:

  • Cash acceleration
  • Claim denials
  • Self-pay collections
  • Electronic remittances
  • Payment processing
  • Financial reporting
  • Payment structures

Due to the many areas that ICD-10 will affect, accounting errors will increase, creating the possibility that overwhelmed finance departments will leave many procedures un-coded.

Five: Revised Documentation Procedures
For coding professionals, ICD-10 implementation means learning a new way to document and process claims. [6] The new system will increase workloads by almost 70 percent and may result in more patients leaving facilities before finalizing the billing process. The new system is also likely to increase the number of patient charts on hold due to coding discrepancies. The ICD-10 system promises to serve the medical community’s classification needs, while adapting to future changes. The system offers physicians a way to record details that may improve caregiving, but implementing the framework is a complex and challenging undertaking. Between universal healthcare, the aging population and ICD-10 implementation – healthcare information technology professionals have never been more important in the medical field.

Sources:
[1] https://www.cms.gov/Medicare/Medicare-Contracting/ContractorLearningResources/downloads/ICD-10_Overview_Presentation.pdf
[2] https://www.unitypoint.org/waterloo/filesimages/For%20Providers/ICD9-ICD10-Differences.pdf
[3] http://altarum.org/health-policy-blog/icd-9-to-icd-10-benefits-and-challenges-of-the-transition
[4] https://getreferralmd.com/2015/11/the-icd-10-deadline-passed-now-what/
[5] http://library.ahima.org/doc?oid=107489#.V-BAU_ArJhE
[6] https://www.medicaid.gov/medicaid-chip-program-information/by-topics/data-and-systems/icd-coding/icd-10-changes-from-icd-9.html

The Role of HIM in Disaster Response

From natural disasters to epidemics and pandemics, health information management (HIM) professionals are playing an increasingly important role in the preparation, administration and management of emergency response. HIM professionals are slated to continue to gain importance in efforts to combat both natural and man-made disasters well into the future. This can range from preparation and […]

Read More

What Communication Skills Do You Need to Succeed in Health Informatics?

Newly enrolled graduate students such as those in the University of Illinois at Chicago Master of Science in Health Informatics enter the program with pre-established healthcare backgrounds in fields such as nursing, pharmacy, information technology or data management. That said, the communications competency profile for graduate-level health informatics students represents a unique blend of knowledge, […]

Read More

The Role of Data in Population Health

Population health, the interdisciplinary field focused on the analysis of health outcomes of large groups of people, is becoming a more common and increasingly effective way of combating medical problems on a vast scale. In the United States, the use of population health data is becoming an effective and increasingly utilized tool in efforts to […]

Read More

The Role of Health Informatics in Preventing Errors in Health Care

Graduates of the University of Illinois at Chicago’s online Master of Science in Health Informatics program are continually taking on newly created positions on the front lines of medical care in hospitals and clinics nationwide. This interdisciplinary study prepares students for the design, development and implementation of technology-based healthcare service innovations in a variety of […]

Read More

What is Information Governance?

Information governance (IG) in health care is defined as the structures, policies, and relevant procedures initiated and adhered to by hospitals, health care providers and medical insurance companies to collect, organize, utilize and secure data. The arena of information governance is concerned not just with extracting value from patient and hospital data but also with […]

Read More

Do Health Apps Work?

From mobile phone programs to wearable health-related devices, health apps, also known as mHealth or mobile health apps, are being utilized more than ever before. mHealth applications are rapidly transforming the way health services and information are accessed, delivered and managed. According to the Health Well Foundation, mHealth apps have already amassed over 60 million […]

Read More

Increasing patient access to medical records

Decades ago, patients who needed their medical information called their primary care provider. The doctor was likely the same person that they’d seen for most of their life and probably had a thick folder with test results and appointment details. But today, the average person sees numerous health care providers throughout their lifetime, from primary […]

Read More

Health informatics and the data deluge

Every time you swipe your credit card, send an email or visit your favorite coffee shop, data is collected. Your fitness tracker counts your steps, your cell phone tracks your location, your streaming accounts monitor your entertainment preferences – and this information adds up quickly. According to Vouchercloud, Europe’s biggest mobile voucher app, the world […]

Read More

What do HIM professionals need to know about applied informatics?

The technological advancements that have exponentially increased the amount of data collected in healthcare are both a blessing and a curse. On one hand, these mass quantities of data have almost limitless possibilities in advancing the efficacy and efficiency of patient care. However, the sheer volume of the numbers collected from sources such as electronic […]

Read More

7 interesting blogs for health informatics students

As a health informatics student, you are constantly learning more about your chosen field through lectures, coursework and text books. But the classroom – whether physical or virtual – is not the only place where you can advance your knowledge of the HI industry. Thanks to the internet, there is a wealth of information available […]

Read More

Career spotlight: Health informatics consultant

In the healthcare setting, it is no secret that pharmaceutical drugs, medical procedures and other elements of patient care are continually developing. And in recent decades, technology has more than kept pace with this rapid speed of advancements. Consider the storage of medical histories and other sensitive patient data. According to a survey published in […]

Read More

HI vs. HIM: What’s the difference?

Health information comes from a variety of sources. It encompasses patient histories, test results, provider’s notes and even numbers from health apps and wearable devices. Combined, these numbers create one of the most powerful resources available to the professionals who provide patient care: big data. However, from the point of gathering that data to actually […]

Read More

The power of health informatics in improving patient outcomes

In the healthcare industry, one of the major ways that success is measured is through patient outcomes. Often defined as the fulfillment of care goals – from both a provider and patient perspective – this metric is important for ensuring that existing practices and procedures are effective and identifying those which are not and should […]

Read More

Career spotlight: Chief compliance officer

The average number of openings created for data professionals each year in the U.S. is on the rise. According to a new report by IBM, yearly openings for data and analytics jobs are expected to increase by 364,000 by 2020, reaching 2.7 million open positions listed annually. This rising demand reflects a workforce inundated by […]

Read More

The role of health informatics in increasing patient engagement

Increased patient engagement is an important goal in modern healthcare. Research has shown that when patients are more engaged in their care, they experience better outcomes, which can improve quality of life and save money for both the consumer and the provider. It is also a metric that health care organizations are required to measure […]

Read More

The impact of health informatics on nursing practice

Informatics is changing the face of healthcare. As technology advances, healthcare organizations and providers are able to collect, analyze and leverage data more effectively, influencing the way care is delivered, resources are managed and teams operate each day. You would be hard-pressed to find an aspect of medicine that has yet to be touched by […]

Read More

3 ways HIM professionals protect patient data

Data is critical in healthcare organizations for identifying, diagnosing and treating patients. Without medical records and other personal health information, providers would not know how to effectively care for a patient – and may not even know exactly who it is that they need to treat. And yet, this sensitive information, though essential, creates a […]

Read More

5 common settings for an HIM career

The management of data is playing an increasingly important role in healthcare. As the ability to collect mass quantities of this data grows, so does the need to protect and leverage the information effectively. Consequently, use of systems that store and protect this information is also on the rise. The most recent numbers from the […]

Read More

Who should pursue an MSHI degree?

Big data, once largely the realm of scientists and mathematicians, is now playing an important role in industries as diverse as entertainment, security and education. And when it comes to this trend, healthcare is no exception, as is demonstrated by the growing field of health informatics. This aspect of data use is providing numerous opportunities […]

Read More

Career spotlight: Clinical Informatics Specialist

Technology is having a profound impact on the healthcare field – including in the number of jobs available to qualified professionals. According to CNBC, healthcare providers around the world are spending more than $100 billion each year on health information technology, such as electronic health records, mobile health applications and online patient portals. As healthcare […]

Read More

How to begin a career in health information management

Health information management (HIM) is a field that combines elements of information technology, science and business to collect, analyze and secure data associated with patient care. As the amount of data managed in healthcare has grown over the past decades. HIM professionals are playing an increasingly important role in the daily management of the databases […]

Read More

Learn more about our admissions