ICD-10 transition may cause information loss, financial trouble

Just as organizations learned the costs of implementing ICD-10 were likely higher than previously realized, now there is a new headache on the horizon: The transition to ICD-10 may also lead to information and financial losses,  according to a study published in the Journal of Oncology Practice.

To anticipate challenges providers might face during the transition, researchers from the University of Illinois at Chicago examined hematology-oncology diagnosis codes because they have fewer ICD-10 codes and it's easier to map them to existing ICD-9 codes.  

Researchers reviewed ICD-9 data from the 2010 Illinois Department of Medicaid, as well as from the University of Illinois Cancer Center (UICC).They analyzed 120 codes with the highest reimbursement, then mapped the loss of clinical information from that format to ICD-10, according to the study.

The transition to ICD-10 led to significant information loss affecting 8 percent of all Medicaid codes and 1 percent of UICC codes, researchers said.Thirty-nine ICD-9 codes with information loss accounted for 2.9 percent of total Medicaid reimbursements and 5.3 percent of UICC billing charges, according to the study.

The results are a concern because previous research indicated that hematology-oncology will likely have an easier transition to ICD-10 compared to other sub-specialties. Instead, the study shows information loss will affect billing costs and could cripple a practice financially. 

ICD-10 includes more than 68,000 diagnostic codes, compared to just 14,000 in ICD-9. A cluster of codes might map to several ICD-10 codes, which might then map back to different ICD-9 codes, study co-author Andrew Boyd, M.D., UIC assistant professor in biomedical and health information science, said an announcement. The report highlights 39 codes "to help identify that there might be trouble with reimburement for these codes," he said. 

The findings come in the wake of a recent report that revealed ICD-10 may also jeopardize some hospitals' credit. Hospitals could experience payment delays and disruptions since ICD-10 affects coding, billing and payment, FierceHealthIT previously reported.

To learn more:
- here's the study
- read the announcement

 

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