ICD-10 Likely to Cause ERs Pain

Let’s concede one point. ICD-10 is going to cause some problems from organizations no matter the side of the current argument they’re on. Whether the current go-forward plan continues or the deadline is delayed again, someone is going to receive a bit of unwanted attention related to the regulation.

The latest news to that end is that emergency departments now possibly could feel the negative effects of moving from the ICD-9 code set to ICD-10, or so says the American Journal of Emergency Medicine in a new report published this month. According to the statement, as many as 25 percent of ERs could face troubles with the new codes.

The problems the new codes could create would likely affect reimbursement and clinical documentation, complicating tasks faced by emergency physicians, such as justifying hospital admissions and reporting certain diseases to public health departments, say researchers at the University of Illinois at Chicago.

The university researchers reported that 27 percent of the 1,830 commonly used emergency room ICD-9 codes had “convoluted mappings that could create problems with reporting or reimbursement.” They also found that when they looked at more than 24,000 actual clinical encounters in the ER, 23 percent “could be assigned incorrect codes if recommendations of the Center for Medicare and Medicaid Services were followed.”

ICD-10, set for roll out on October 1, includes more than 68,000 diagnostic codes — compared to 14,000 in ICD-9.

The researchers reported that during the past two years they have reviewed how ICD-9 codes map to ICD-10 codes, “not only for emergency medicine, but for other problematic areas, including pediatrics, patient safety reporting and long-term research.” Some ICD-9 indicator codes translate well, and some don’t map at all.

In this data set, researchers looked specifically at the codes used most often by emergency physicians, to see where problems may arise.

“Despite the wide availability of information and mapping tools, some of the challenges we face are not well understood,” said Dr. Andrew Boyd, assistant professor of biomedical and health information sciences at UIC and principal investigator on the study, in a statement.

It’s worth noting that as the transition approaches, the headlines loom and that worries remain over ICD-10, especially for small practices, as NueMD has recently reported through its survey on the topics. According to FierceHealthIT, practice leaders are concerned about and feel underprepared even though they’re had a good deal of time to prepare, saying their comfort level is a little less than it should be.

The university’s report authors say about the findings of their study: “These challenges, if not addressed, may carry significant cost and workflow issues that will be shared by providers and payers alike.”

No matter the effect they have on healthcare organizations, perhaps we should also concede that some practices and providers are simply going to need some help getting to their goals, before and even after the transition.

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