Benefits Outweigh the Costs
Extensive development and evaluation of ICD-10-CM/PCS as replacements for ICD-9-CM have been conducted. This includes system testing, completion of a comprehensive cost/benefit analysis, and hundreds of hours of testimony by experts who examined all sides of the issue.
The cost of doing nothing may be greater than implementation. Continuing to use ICD-9-CM will increasingly have an adverse impact on the value of healthcare data, including the accuracy of decisions based on faulty or imprecise data. Additionally, any delay in adoption of ICD-10-CM/PCS will cause an increase in future implementation costs. As the management of health information becomes increasingly electronic, costs of implementing new coding systems will increase due to required systems and application upgrades.
The Rand Report is an independent study commissioned at the request of the National Committee on Vital and Health Statistics (NCVHS). Rand concluded that benefits of ICD-10-CM/PCS are likely to exceed initial implementation costs within just a few years.
Implementation costs include:
- Training
- Lost productivity during implementation and training
- System upgrades/changes
Future benefits include:
- More accurate payment for new procedures
- Fewer miscoded, rejected, and improperly reimbursed claims
- Better understanding of the value of new procedures and healthcare outcomes
- Improved disease management
AHIMA/AHA Field Study
In 2003, AHIMA and AHA conducted a field-test of ICD-10-CM medical code sets. The study shows ICD-10-CM is a significant improvement over the current ICD-9-CM coding system and can be implemented without excessive staff training costs or changes in documentation practices. Training ICD-9-CM users to use ICD-10-CM was shown to be relatively straightforward as ICD-10-CM retains the traditional ICD format and many of the same conventions. New training methods and the Internet will support cost effective retraining of coders.
NCVHS Testimony
AHIMA testified before the NCVHS that adoption of ICD-10-CM and ICD-10-PCS would serve as a catalyst for the development of computer-assisted coding applications. In the NCVHS testimony, as well as in a practice brief titled “Delving into Computer-Assisted Coding,” several benefits of the use of computer-assisted coding technology were described:
- Increase in coding productivity
- Increase in coding consistency
- Increase in coding accuracy
- Enhanced coding compliance
- Potential decrease in coding costs
- Better documentation at lower cost
Report on the Use of HIT
As supported by AHIMA’s “Report on the Use of Health Information Technology to Enhance and Expand Health Care Anti-Fraud Activities,” prepared under contract to the Office of National Coordinator for Health Information Technology, adoption of ICD-10-CM and ICD-10-PCS will facilitate the prevention and detection of healthcare fraud. This report includes the following guiding principle in its conclusion and recommendations: “Standardized reference terminology and up to date classification systems that facilitate the automation of clinical coding are essential to the adoption of interoperable EHRs and the associated IT enabled healthcare fraud management programs.”