ICD-10 Transition Successful So Far, but Patient Care Takes Hit

Two new polls show mixed results since the Oct. 1 ICD-10 compliance date went into effect. While a survey by consulting firm KPMG found 79 percent of responding healthcare organizations believe the code transition has been successful to date, a separate survey of doctors by physician social media network SERMO indicates the new billing codes are taking time away from patient care.


Two new polls show mixed results since the Oct. 1 ICD-10 compliance date went into effect. While a survey by consulting firm KPMG found 79 percent of responding healthcare organizations believe the code transition has been successful to date, a separate survey of doctors by physician social media network SERMO indicates the new billing codes are taking time away from patient care.

In the KPMG survey of 298 attendees conducted during a Nov. 9 webcast, 28 percent of participants responded that the transition has been “smooth” and another 51 percent found “a few technical issues, but overall successful.”  At the same time, 11 percent described their experience with the code set as a “failure to operate in an ICD-10 environment.”

KPMG survey respondents said the biggest challenges they perceive with ICD-10 include rejected medical claims, clinical documentation and physician education, reduced revenue from coding delays, and information technology fixes. The survey found that 42 percent of participants indicated that all of these challenges are part and parcel of ICD-10., while just 11 percent of respondents said they did not expect those challenges to arise.

“We’re still in that gray area where claims are still being processed by payers, so I would expect the number of technical-related issues to increase in the January/February timeframe,” says Todd Ellis, managing director in KPMG’s healthcare practice. “Very few payments have been made. The ICD-10 journey is not over yet.”   

In the SERMO survey, physicians were asked if the new requirement to use ICD-10 has taken away time from patients. Two-thirds of responding doctors said yes. The poll of 1,249 physicians was conducted from November 20 to 30.

Although doctors strongly indicated that the code switchover has detracted from patient care, that percentage is down significantly from a SERMO poll last month that asked members if ICD-10 was taking their time away from patient care. At that time, 86 percent said it had negatively impacted patient care while only 14 percent said it had not.

Also See: ICD-10 Drives Down Hospital Coder Productivity

KPMG has not attempted to gauge physician productivity as a result of the ICD-10 implementation. However, Ellis says that the firm has been reaching out to its clients since the Oct. 1 compliance date went into effect and has found that coder productivity has been negatively impacted.

“We have seen a decline with our clients in terms of coder productivity by around 10 percent,” he acknowledges, yet emphasizing that it is a far cry from the 30-40 percent reduction reported by other industry surveys. “As we go through this upcoming calendar year, I think that productivity will increase.”

In KPMG’s ICD-10 survey, 46 percent of respondents said they were considering clinical documentation improvement, revenue cycle optimization, and electronic health record and IT system optimization initiatives.  Nonetheless, the poll also revealed that 25 percent of those surveyed are not pursuing any of those options.

“Organizations cannot look at ICD-10 as a one-time, Y2K-type event. This is very far-reaching and goes way beyond Oct. 1,” concludes Ellis. “There is a direct correlation between clinical documentation and revenue cycle. If you have poor documentation, it will impact your bottom line.”

He hastens to add that the opposite is also true. “Organizations that institute better documentation will see an increase in revenue, so for those 11 percent who are struggling right now I would highly encourage them to do an ICD-10 assessment from a clinical documentation improvement, revenue cycle optimization, and EHR optimization perspective.”  

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