ORLANDO, FL – Converting to the ICD-10 medical diagnosis code set isn’t for the faint of heart. It’s likely to be complicated and expensive, and may entail a loss of productivity that could take five to six years to gain back, according to experts. The conversion is federally mandated by Oct. 1, 2013, and there’s no indication it will be postponed. Orlando Health, a provider of healthcare services in central Florida, is forging ahead to meet the deadline.

“We do have an organizational methodology,” said Sharon Addison, senior project manager for ICD-10 at Orlando Health. “We know the steps, we’re executing those steps as we speak, and we will comply on Oct. 1, 2013.”

Addison was part of an Orlando Health panel on ICD-10, organized by the College of Information Management Executives, at HIMSS11 last month.

As she noted, ICD-9 consists of 17,500 codes, while ICD-10 has about 157,000 codes. However, ICD-9 is 30 years old, and ICD-10 offers the “granularity and specificity” that ICD-9 can’t, she said.

“It’s a pretty dramatic change in healthcare,” she added. “It really is a project that touches every single entity inside Orlando Health."

While the gravity of the project may still be setting in for some organizations, "the sky is not falling," said Mark Williams, RN, a partner in the Health Industries segment of PricewaterhouseCoopers. "It's big, but we do think it’s manageable."

Training and communication will be vital at Orlando Health, Addison said, because incorrect documentation leads to inaccurate coding, which impacts reimbursement.

Also, Addison suggested, “if you’re spending millions of dollars on a project this size, you should look for other parts you can do to improve process and other aspects.”
Alexander Veletsos, chief applications officer at Orlando Health, agreed. But, he cautioned, “It’s almost like assessing a moving target.”

Bridget Walters, corporate director of patient accounting, said conversion to the ICD-10 code set will save money because it provides more specific coding. “We’re hoping ICD-10 will decrease denials,” she said.
The average time for billing after services is five days. Walters said ICD-10 could triple that time. Accounts receivable, which stands at 49 days, she said, could also triple.

The project is certain to cost millions, said Veletsos.

Addison said most healthcare organizations the size of Orlando Health, which operates eight hospitals and 49 physician practices, are as prepared or slightly ahead of Orlando Health in their ICD-10 work. But it’s a lot tougher for small community hospitals to achieve, and vendors and payers are struggling with the conversion, too.

“It's an opportunity to do a lot of things that need to be done in healthcare on the payer side and the provider side … to fine-tune business rules to leverage data to get better results,” said Sydney V. Ross-Davis, MD, who serves as ANSI 5010/ICD-10 healthcare management project lead at the Health Care Service Corporation, a customer-owned benefits company. Ross-Davis coaches payers, providers and vendors on how best to benchmark progress on the road to implementation.