Why ICD-10 implementation is expected to create productivity losses

By Carl Natale
08:13 AM
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There is conventional wisdom that too many ICD-10 codes is going to make it harder for clinicians and medical coders to do their jobs.

Thus some studies suggest a 50 percent or more drop in medical practice productivity. The Nachimson Advisors study on ICD-10 implementation costs takes a look at productivity and puts a price tag on it. Here's what it estimates:

  • $8,500 to $20,250 for small medical practices
  • $72,649 to $166,649 for medium medical practices
  • $726,487 to $1,666,487 for large medical practices

Here's what the Nachisom study used to explain productivity losses:

  • Medical coders are taking on new roles helping medical practices use electronic health records (EHRs) and work with data. This means they can process fewer medical records.
  • Medical coders have learned to recode ICD-9 errors instead of querying physicians. That will become harder with ICD-10 codes. Thus physician queries will increase.
  • The Nachisom study estimates that ICD-10-CM will mean a 10 percent drop in physician productivity.
  • ICD-10 coding is expected to increase documentation time by 15 percent for physicians.

This seems rather tame compared to what all can go wrong. Lisa Eramo takes a stab at explaining how ICD-10 coding can affect medical coding productivity at For the Record.The ICD-10 learning curve, current workflow inefficiencies, denial management and an increase in patients (thank you Affordable Care Act) will slow medical coders down.

More importantly, the article covers what can be done to mitigate medical coder productivity losses:

  • Practicing ICD-10 coding on real medical records will be a major benefit. Although taking the time to do that is another way to decrease productivity.
  • Hiring coding help will keep medical claim processing moving. Start lining it up now because ICD-10 trained medical coders will be in demand.
  • While medical coders should be versatile, focusing specific coders on specialties should increase productivity.
  • Clean up the  discharged not final billed (DNFB) so it's not slowing down medical coders trying to get a handle on ICD-10 codes.
  • Automation can boost efficiency and productivity if is done right. Curiously, the National Pilot Program attributed many errors to over reliance on computer assisted coding (CAC) systems.
  • Prepare management for the loss of productivity.
  • Schedule testing with healthcare payers. You need to learn now how bad your denial rate will be so you can start correcting problems.

ICD-10 doesn't have to be a practice killer. Educating clinicians and coders now will protect medical practices from the worst after Oct. 1.