Conversion to ICD-10 to Run Into Multi-Millions, CMS Says

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Costs associated with conversion to the ICD-10 code set may total $640 million in 2013 alone, the Centers for Medicare and Medicaid Services (CMS) revealed Wednesday during a briefing virtual briefing held by the Healthcare Information and Management Systems Society (HIMSS).

Data from the American Society of Clinical Oncology, cited during the presentation by Denise O. Hall, RN, BSN, a shareholder at health care consulting firm Pershing Yoakley & Associates, indicates that heath care organizations with 400 or more beds will need to spend $1.5 million to $5 million to execute an ICD-10 conversion. Hospitals with 100 to 400 beds can anticipate conversion expenditures of $500,000 to $1.5 million; those with fewer than 100 beds, investments of $100,000 to $250,000.

Meanwhile, in 2015 alone, health care providers will incur about $329 million in productivity losses stemming from improper and returned claims. System changes for providers will bear a price tag of $75 million.

Hall told viewers of the briefing that documentation will be a critical component of the ICD-10 conversion process. She said there remain concerns that Medicaid programs’ continued use of “archaic” code sets introduced before ICD-9 will impede its transition. However, she believes most commercial payors will be ready to make the switch.

“Documentation will be vital in this process,” Hall noted. So, too, will conversion, education, and training, she reported.

HIMSS has issued an advisory on planning for the conversion, available here: http://www.himss.org/asp/ContentRedirector.asp?ContentID=74886.