OC Reilly Blog: Checking Under the ICD-10 Hood

By Ray Staudt, Executive Director, Business Development, OC Reilly Inc.


(Jan. 25, 2016)–Every three months or 3,000 miles, we’re advised to check under the hood to see how things stand. Change the oil, check the tire pressure and see if its’ time to rotate them, top off all the fluids, test the lights – because it’s the little things we take for granted that can cause serious problems down the road.

Health care providers would be well advised to take that same sort of advice these days regarding their ICD-10 procedures and results.

On October 1, 2015, ICD-9 was replaced by ICD-10. The upgrade became necessary because the ICD-9 code set had not be able to expand to accommodate additional disease classification or newly identified diseases. ICD-10 includes a larger mix of numbers and letters to increase the number of diagnosis codes available.

So, now that this new coding system has been in place for a while, let’s take your system in for a three-month tune-up, by asking:

  • How well is it working?
  • What sort of issues and points of confusion have been documented?
  • Have they been addressed?
  • What have those problems meant, in terms of lost reimbursements, wasted staff time, and other key considerations?

In the November 2015 edition of HFM magazine, Healthcare Financial Management Association President and CEO Joseph J. Fifer writes:

“Successful ICD-10 implementation begins with thorough preparation, but it doesn’t end there. Over the coming months, providers should monitor revenue cycle performance closely through metrics such as HFPA’s MAP keys and take steps to stabilize cash flow and other financial results, as needed. Also, payers and providers alike should assess the impact of ICD-10 on payment levels and make appropriate changes in contractual provisions.”

It’s been a little over three months now, since ICD-10 took effect. This might be a good time to take a look under the hood again, to make sure all systems are in top working order – and to make the ride to proper operations and reimbursements as smooth as possible.