Revving Up for ICD-10 Amid Wheel-Spinning—Just How are the Coding Enactment Delays Affecting Revenue Cycle?

May 4, 2015

How much of a roadblock do the ICD-10 implementation delays represent for revenue cycle operations and integrity? How can you keep from spinning your wheels so you can make it to the finish line on time? Health Management Technology explores progress on the revenue cycle front despite the uncertainty of ICD-10’s rescheduled Oct. 1 deadline.

Hazards averted?

To those who might define revenue cycle around the transactional function of charge capture, views are mixed on whether the ICD-10 implementation delay is disruptive or even hazardous….

…Crystal Ewing, Senior Business Analyst and Manager, Regulatory Strategy, ZirMed, urges healthcare IT professionals to look on the bright side and think positively.

“ICD-10 brings a wealth of additional granularity and new, rich data points,” she emphasizes. “The revenue cycle world should welcome ICD-10 with open arms – they just need to be sure they have the IT horsepower to harness it. Data mining is the key to uncovering missing charges rather than simply flagging the obvious ones, so the potential depth and precision of any charge integrity analytics are directly tied to the granularity of the data, which will increase dramatically with the implementation of ICD-10.”

Making fixes on the run

Until ICD-10 becomes effective this October, how can healthcare IT improve the revenue cycle process for better margin management?

ZirMed’s Ewing takes a long view.

“You need upstream intelligence,” she insists. “By that I mean your analytics have to run upstream from the charge information and determine whether there’s a more appropriate code that would also lead to higher overall reimbursement. That has to happen before the claim is submitted to the payer, which is only possible at the enterprise level through the application of predictive analytics – the data is far too massive to manage manually.”

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