Survey shows ICD-10 easier than first reported

Rural docs on Capitol Hill today to speak at Congressional briefing
By Bernie Monegain
11:07 AM
Counting coins

For physicians in small practices, it turns out the cost of moving from ICD-9 to ICD-10 is much less than anticipated, according to a new study released today by the Professional Association of Health Care Office Management.

The survey of 276 physician practices of fewer than six providers revealed that total ICD-10 related costs for an entire practice averaged $8,167. Per provider expenditures averaged $3,430.

The survey results were published today in the Journal of AHIMA.

The findings would not surprise Deborah McEuen, practice manager at Beyer Medical Group, a six-provider practice in Fredericktown, Mo. She and two of the practice's doctors were headed to the nation's capital on Monday to talk about their experience at a Congressional briefing on Capitol Hill today.

The Coalition for ICD-10 is hosting the briefing on ICD-10 readiness, featuring the perspectives of leading physicians and also the PAHCOM on the cost of ICD-10 conversion. 

Also participating in the briefing is Nemours Children's Health System, a large organization and research institution with more than 50 facilities across five states; and Florida Blue Cross Blue Shield.

When McEuen told the practice's founder Phillip Beyer, DO, the practice needed to get serious about ICD-10, he said, "whatever you need."

[See also: Outlook grim for docs' ICD-10 readiness.]

She forged ahead with a pilot that employed the practice's Intergy electronic health record.

When the Oct. 1, 2014, deadline for conversion to ICD-10 was postponed, she and the doctors continued to code in ICD-10 in diagnosing and the charts – using ICD-9 only for billing purposes.

"In fact, it's probably simpler than ICD-9," she said, "because they are more clear," she said. "My providers love it; they wouldn't go back. They love the specificity of it. They feel when they are choosing a code it really represents what they're trying to say. It paints a much clearer picture."
No downside?

"No, not for us," McEuen said. "We didn't have the cash outlay; we didn't have the training. We didn't have adjusted schedules, cranky providers. Nothing."

McEuen's experience seems to correspond with the findings of PAHCOM's ICD-10 survey.

"We hear so much conflicting information about the impact of ICD-10 on the small physician practice," said PAHCOM Director Karen Blanchette, in a statement announcing the survey results. "Our goal was to bring some clarity to the discussion by surveying our members – office managers who represent hundreds of solo physician and small group physician practices across the United States.

[See also: Senators confident ICD-10 is a go.]

"Our members reported actual data on expenses to date and costs still remaining," Blanchette added. "The PAHCOM survey is the most comprehensive and current data on ICD-10 implementation costs actually being incurred by small physician practices."

Survey respondents were asked to specify the number of providers in the practice, where a provider was defined as a direct caregiver including physicians, physician assistants and nurse practitioners. Survey questions on total expenditures for all ICD-10 related activities specifically highlighted the cost of ICD-10 manuals and documentation, ICD-10 training costs, the cost of "super bill" conversion, software system upgrades and testing.

The ICD-10 expenditures reported in the survey are significantly lower than earlier estimates of $56,639-to-$226,105 in projected ICD-10 implementation costs for small physician practices.

Survey of ICD-10 Implementation Costs in Small Physician Offices was co-authored Blanchette, Richard Averill, senior vice president, public policy for 3M Health Information Systems, and Susan Bowman, senior director, coding policy and compliance for AHIMA.

Topics and speakers at today's Capital Hill briefing are:

  • Small Rural Provider Readiness – Edward Burke, MD and Phillip Beyer, D.O., Beyer Medical Group, Fredericktown, Mo
  • Countdown to ICD-10 for Hospitals – David W. West, MD, medical director, health informatics, Nemours Children’s Health System
  • New Survey on ICD-10 Conversion Cost for Small Physician Practices – Karen Blanchette, director of Professional Association of Health Care Office Management
  • Payer Testing and Readiness – George Vancore, senior manager, systems mandates and compliance, Florida Blue Cross Blue Shield