Delaying ICD-10 Planning Could Significantly Hurt Hospital Finances

Healthcare reform legislation has inundated hospital leaders with new responsibilities, requirements and initiatives. For example, hospitals need to improve coordination of care, whether by creating an accountable care organizations or forming different types of relationships with other healthcare organizations, retail clinics and payors. As part of HITECH, hospitals are focusing on becoming "meaningful users" to be eligible for incentives. Hospitals must be HIPAA compliant with 5010 by Jan. 1, 2012 and ICD-10 by Oct. 1, 2013. Pressure to survive is mounting.

Belinda Wiegand, RHIA, CPHIMS, senior director of eHealth at Anthelio Healthcare Solutions, says transitioning to ICD-10 should be one of hospitals' top priorities. "The focus today has been on meeting meaningful use, participating in health information exchange and ACOs. Organizations tend to "push back" on ICD-10 because 2013 is a future date. However, failure to plan and prepare now could be financially devastating to an organization," she says. Delaying work on 5010/ICD-10 can impact the organization's financial stability due to delayed or rejected claims caused by non-specific documentation in the patient's medical record resulting in inappropriate coding, and thus reimbursement.


Ms. Wiegand says, "Hospitals need to develop their strategy quickly to provide time for the 5010/ICD-10 transition. A key critical success factor is using a multi-disciplinary approach whereby multiple stakeholders work together."

In addition to approaching the change as an organization-wide event, Ms. Wiegand suggests hospital leaders "obtain confirmation in writing" that their vendors will be 5010 and ICD-10 compliant by the deadlines. If the vendor will not be ready, hospitals will need to strategize how to update and test their systems, Ms. Wiegand says.

Learn more about Anthelio.

Related Articles on ICD-10:

Providers Could Save Time, Money by Implementing ICD-10 and Meaningful Use Together
HIMSS: Robust Education Effort Needed for 5010, ICD-10 Compliance

CMS Creates Timeline Widget for HIPAA 5010, ICD-10 Planning




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