According to a new report from University of Illinois at Chicago researchers, health care providers may experience financial loss and information losses during the upcoming required conversion from the current International Classification of Diseases (ICD) to its new version. The study, which appeared in the Journal of Oncology Practice, examined coding ambiguity for hematology-oncology diagnoses to anticipate challenges that all providers may face with the transition to ICD-10, scheduled to be implemented October 1.
The research team used 2010 Illinois Medicaid data to identify ICD-9-CM outpatient codes and the associated reimbursements used by hematology-oncology physicians. The researchers identified 120 codes with the highest reimbursement for analysis. Also, the researchers looked at ICD-9-CM outpatient diagnosis codes and associated billing charges utilized by the University of Illinois Cancer Center physicians from 2010 to 2012 and selected the 100 most-used codes.
According to a University of Illinois at Chicago news release, the research team used a web-based tool to input the ICD-9 codes and translated them into ICD-10 codes. The team looked at the following: whether the translation made sense; whether a loss of clinical information occurred; and whether a loss of information had financial implications.
Neeta Venepalli, MD, the first author of the study, “What we found was the transition from ICD-9 to ICD-10 led to significant information loss, affecting about 8 percent of the Medicaid codes and 1 percent of the codes in our cancer clinic.” In addition, looking at the financial implications, the researchers found that 39 ICD-9-CM codes with information loss accounted for 2.9% of total Medicaid reimbursements and 5.3% of University of Illinois Cancer Center billing charges.
Andrew Boyd, MD, co-author of the study, states the report also highlights the 39 codes “to help identify that there might be trouble with reimbursement for these codes.”
[Source: University of Illinois at Chicago]