ICD-10 for Radiology Ramifications

This article was originally posted on McKesson's Imaging Talk Blog: Written by: Nicole Wichlei

When the new ICD-10 system is implemented on October 1, 2015, which is the most recent date set for its onset, many changes will accompany the transition, including a dramatic increase in the number of codes. The increase will be helpful to practitioners, including those in radiology, because it allows them to improve the specificity they use when documenting why a patient was seen and what care was given.

The current ICD- 9 system is more than 30 years old—think of all of the advancements medical imaging has experienced in that time. That means that ICD-9 contains outdated radiology information terminology and limited data and simply does not align with how physicians today practice. Updating to ICD-10 for radiology requires in-depth work and preparation by practitioners throughout your medical organization. As we prepare for ICD-10’s implementation, your staff will see the following changes:

Increasing Number of Codes. There will be more than four times as many codes under ICD-10 as there are under the current ICD-9 system. The number of codes will increase from the 14,000 currently used to more than 69,000, requiring radiologists and referring physicians alike to be extremely particular with radiology information, diagnoses and documentation.

Decreased Productivity. As healthcare organizations adopt the new system, productivity is expected to go down while staff members adjust to the changes. A report from the American Hospital Association states that physicians should ensure that they have provided sufficient documentation for coders, being particularly aware of any laterality specifications that may be required. Coders will see the biggest changes, and a loss of productivity for them could affect medical organization’s revenue cycles.  Within medical imaging, ICD-10 for radiology means anticipating a potential drop in efficiency and adjusting schedules and work load as needed.

Growing Requirements in Clinical Data Reporting. Another change that will affect radiologists is in the area of clinical data reporting. Radiologists by design have to rely on referring physicians and others for documentation. How referring physicians document proof of medical necessity may affect radiologists’ reimbursement.

The American College of Radiology recommends that members start preparing now for the change. Healthcare facilities should update billing software, train staff, and test the new systems as soon as possible. The Centers for Medicare and Medicaid Services (CMS) estimates that testing will take up to 19 months, and recommends that organizations test claims, eligibility verification, quality reporting and other transactions to ensure that ICD-10 codes are being processed correctly well in advance of the deadline.  The ACR has webinars, podcasts and even timelines available for referral.

Someone once said the only constant is change, and physicians know this well. ICD-10 implementation may have been delayed, but now is the time to get ready for the change. ICD-10 for radiologists means learning, testing and reporting so that when next October comes, you can transition as smoothly as possible.

Learn how McKesson and its Qualitative Intelligence Communication System (QICS ™) can help your healthcare organization better prepare for ICD-10. Learn more about these workflow solutions:

  • QICS™ for Coding Discrepancy Management
  • QICS™  for Critical Results Management
  • QICS™ Physician Quality Review System (PQRS)

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