Emergency departments will feel negative impacts from the changeover to the new ICD-10 coding system, according to a paper published this month in the American Journal of Emergency Medicine.
Currently, about 27 percent of emergency department ICD-9 codes are convoluted and could point to problems with clinical workflow and financial health at hospitals, according to the report. Those problems will continue when the switch to ICD-10 occurs, the researchers--from University of Illinois at Chicago--say. ICD-9 has only 14,000 codes, while ICD-10 will have more than 68,000.
Changes to diagnostic codes for OB/GYN in ICD-10 also have potential for incorrect mappings that could create cost problems for EDs, the authors add. They cite prior studies that show convoluted mappings and information loss in non-ED settings, such as pediatrics and hematology-oncology.
"Despite the wide availability of information and mapping tools, some of the challenges we face are not well understood," Andrew Boyd, M.D., assistant professor of biomedical and health information sciences at UIC and principal investigator on the study, says in an announcement.
Problems due to ICD-10 will be more widespread for independent physician groups that staff EDs and perform their own billing, according to the report. They will be overwhelmed by the amount of analysis and challenges in ICD-10, the authors say.
Worries remain over ICD-10, especially for small practices. According to a survey from NueMD, a billing and practice management software vendor, the level of concern about ICD-10, especially among small practices, is "a little too high for comfort."
The deadline for implementation currently stands at Oct. 1, following many delays. However, some in the industry are pushing for the new code set to be delayed once again, or thrown out. In addiiton, a new bill introduced in the House would require end-to-end testing of the transition by the Health and Human Services Department, with an 18-month transition period.
"ICD-9-CM to ICD-10-CM transition is not straightforward and contains hidden mapping and planning challenges that may have not been accounted for even at this late stage of the sprint toward ICD-10-CM implementation," the report's authors say. "These challenges, if not addressed, may carry significant cost and workflow issues that will be shared by providers and payers alike."
The researchers created a free tool that providers can use to get a report on the ICD-9 to ICD-10 code mappings.