ICD-10 Two Months In: Consultants Give an Inside Look at How the Transition Has Impacted the Industry

Leading up to the healthcare industry’s transition to the ICD-10 coding set on Oct. 1, 2015, there seemed to be a collective feeling of uncertainty on the part of providers—particularly physician practices that frequently expressed doubt about their readiness for the shift. What’s more, numerous pieces of legislation were introduced into Congress, several of which advocated a “grace period” where healthcare providers’ ICD-10-based claims submitted to Medicare and Medicaid would not be denied due to coding errors. This led to providers becoming even more leery if the transition would indeed occur on the set date, given that it was delayed three times previously. As such, many organizations were additionally unsure of the impacts that the transition would have on productivity and cash flow.

Despite all this perplexity and trepidation, the implementation deadline was not moved and the industry made it through Oct. 1 sans disaster. At the end of October, the Centers for Medicare & Medicaid Services (CMS) reported that claims have been processing normally since the transition, with 10 percent of claims being rejected and only .09 percent rejected due to invalid ICD-10 codes. However, Medicare claims take several days to be processed and, once processed, Medicare must– by law – wait two weeks before issuing a payment.  Medicaid claims can take up to 30 days to be submitted and processed by states...