The proposed three-year transition from the ICD-9 codes to ICD-10 codes by 2011 could become a big mess resulting in as much as 25 percent more billing errors and denied claims, according to a study by the Blue Cross and Blue Shield Association.
Physicians and insurers are complaining that the Centers for Medicare and Medicaid Services’ proposal doesn’t give the healthcare industry enough time to switch. "The [three-year] time frame proposed is unworkable in the real world," Alissa Fox, vice president for legislative and regulatory policy at the Blue Cross and Blue Shield Association told the Wall Street Journal.
CMS estimates that coding errors and denied claims would initially increase by 10 percent. In August, CMS announced its proposed rules, and the agency plans to publish a final version by the end of the year.
The United States is one of the few remaining countries using the ICD-9 system, which is more than 30 years old. The ICD-10 system has 155,000 different codes to describe diagnoses and procedures, nearly 10 times more codes than the ICD-9 system. The ICD-9 set contains 17,000 codes and is expected to run out of codes next year.
More detailed ICD-10 descriptions would allow healthcare facilities to recover more money in reimbursement for more advanced procedures. However, for providers, the transition will be costly because it will require new software and more training for coders. CMS estimates that the switch in codes will cost the healthcare industry $1.64 billion over 15 years, according to the article.
—Kent Steinriede
