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.  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.  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.  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.  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.  Caregiving facilities will experience backlogs in information processing such as:
- 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.  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.
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
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
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
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
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
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
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
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
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
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
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
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
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
Pharmacy practice is an integral component of the healthcare system in the U.S. From the creation of drugs to the distribution of prescriptions, there are a large number of steps that go into getting the right medication into the hands of the right patient at the right time. Today, as in much of the healthcare […]Read More
Health informatics professionals are tasked with the important responsibilities of obtaining, storing, organizing and leveraging data to improve the services provided by the healthcare industry. As data becomes an increasingly important resource in this field, demand for professionals who can efficiently and effectively work with this information is also on the rise. If you are […]Read More
The field of health information management offers a number of interesting career paths for qualified professionals. Located in a variety of settings, HIM positions are typically tasked with resolving challenges that involve the quality, integrity and safety of protected patient information. It is the perfect field for the professional whose interests lie at the intersection […]Read More
It has become increasingly clear that cybersecurity is a risk factor in health care data. Data breaches cost the health care industry approximately $5.6 billion every year, according to Becker’s Hospital Review. The Breach Barometer Report: Year in Review additionally found that there was an average of at least one health data breach per day […]Read More
Data is increasingly proving to be valuable in the field of health care. The copious amounts of information that are collected, analyzed and leveraged every day are used to trend population health, decrease unnecessary spending, improve best practices, enhance patient care and more, contributing to the efficiency and efficacy of health care organizations across the […]Read More
The field of health informatics is on the rise. Between advancements in health care technology and new government mandates that require detailed reports on a variety of metrics, an increasing amount of data is collected and leveraged every day. Consequently, there is increased demand for professionals who have the skills and knowledge necessary to work […]Read More
The collection, storage and analysis of data is playing an increasingly important role in the healthcare field, as are the professionals who work with this information. The 2017 HIMSS Leadership and Workforce Survey found that 61 percent of vendors/consultants and 53 percent of hospitals had increased the size of their IT workforce in the last […]Read More
The use of data in health care is on the rise. According to a report by Market Research, the market for big data in health care is expected to increase globally to $35 billion by 2021. Through the collection, storage and analysis of this health data, organizations have the potential to save money, improve patient […]Read More