ICD-9 to ICD-10, The Journey and the Cost By: Bill W. Childs

1
ICD-9 to ICD-10, The Journey and the Cost By
Bill W. Childs

• Many Authorities on the subject say that ICD-9 to
  ICD-10 is as onerous as Y2K!

2
Information Explosion

• Information Explosion
• Time Line Number of Years
• 4000 BC to 1800 AD 5,800 years
• 1800 AD to 1900 AD 100
• 1900 AD to 1945 AD 45
• 1945 AD to 1960 AD 15
• 1960 AD to 1970 AD 10
• 1970 AD to 1975 AD 5
• 1976 AD to 2010AD 1

3
Information Explosion 2

• Storage Capacity Costs
• Bytes Dollars
• Megabytes Hundreds of Dollars
• Gigabytes Thousands of Dollars
• Terabytes Millions of Dollars
• Petabytes Trillions of Dollars
• Exabytes Quadrillions of
• Zettabytes Quintillions of
• Yottabytes Sextillions of

4
Technology Explosions

• Medicine
• Clinical / Medical Information Systems
• High Speed Internets and Web Pages
• Cell Phones
• Storage and instant retrievals
• Standards
• Invasive and Non-Invasive Patient Monitoring

5
Quality Improvement via I.S.

• Continuous Monitoring of Patients V/S
• Temperature, Pulse, Respiration, BP
• Blood Sugars, Respiratory rates
• Electrolyte Balances
• INRs, Oxygen saturation, Heart rate
• Heart Valve Performance
• This list goes on and on

6
ICD-9 to ICD-10 Code Explosion

• Twice the number of diagnosis codes
• Twenty times the number for injuries
• Fifty times the number for New Medical Procedures
  
• These of course are all updated once a year on
  October 1st.

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Time Lines

• On October 1,2013 all claims processing must be
  transitioned to ICD-10 codes.
• Beginning January 1, 2011 CMS will begin
  accepting ICD-10 Codes.
• ICD-11 will be accepted in 2011 and must be
  implemented by 2015

8
COST?

• Nationally between One and Two Billion dollars
  spread over
• Hospitals
• Physician Offices
• Payers
• Government
• Vendors of Systems

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Cost Entities

• Management Building a plan
• Discovery Phase
• Contract Renegotiation between ICD-9 and ICD-10
  with 3rd Party Payers
• Training, Training Training
• New Procedures
• Systems changes to accommodate logic and new
  procedures (more field length)

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Estimated Cost by Provider

• Hospitals
• 400 Beds 500K to 2 Million
• 200 to 400 Beds 250K to 1 Million
• 100 to 200 Beds 150K to 500 K
• lt 100 Beds 35K to 150K

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Estimated Costs by Physicians

• Size of Practice or Clinic Cost
• 21 Plus 50,000 to 100,000
• 11 to 20 20,000 to 40,000
• 6 to 10 10,000 to 20,000
• 3 to 5 5,000 to 10,000
• 1 to 2 2000 to 8,000

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Potential Benefits

• More accurate benefits for new procedures.
• Fewer miscoded, rejected and improper
  reimbursement claims.
• Better understanding of the value of new
  procedures
• Improved understanding and classification of
  disease management.
• Better understanding of Healthcare outcomes.

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The End!

• Lost Productivity?
• If ICD-10 not ready or wrong there will be no
  reimbursement from any 3rd party payers.
• So much to do so little time
• Meaningful Use
• HIPAA 5010
• ARRA
• ICD-10