Featured Research

from universities, journals, and other organizations

Transition to ICD-10 may cause information, financial losses for providers

Date:
March 12, 2014
Source:
University of Illinois at Chicago
Summary:
Health providers may experience information and financial loss during the mandated conversion from the current International Classification of Diseases to its new and improved version, report researchers. Coding ambiguity for hematology-oncology diagnoses were studied recently to anticipate challenges all providers may face during the transition from ICD-9-CM to ICD-10-CM.

Health providers may experience information and financial loss during the mandated conversion from the current International Classification of Diseases to its new and improved version, report researchers at the University of Illinois at Chicago.

Related Articles


The study, appearing in the March issue of the Journal of Oncology Practice, looked at coding ambiguity for hematology-oncology diagnoses to anticipate challenges all providers may face during the transition from ICD-9-CM to ICD-10-CM.

The researchers chose to look at hematology-oncology because prior research suggested that, compared to other sub-specialties, it would have a simpler transition, due to fewer ICD-10 codes and less convoluted mappings.

The nation's health care system is scheduled to fully implement ICD-10 on Oct. 1, and many doctors and hospitals are still preparing for the transition. The system is used to classify and code all diagnoses, symptoms and procedures for reference in managing all aspects of health care -- from insurance reimbursement to staffing decisions to supply procurement.

The ICD-10-CM includes more than 68,000 diagnostic codes, compared to 14,000 in ICD-9-CM. The Centers for Medicare and Medicaid Services provides a general equivalent mapping (GEM) code translation system, but it's complex and often difficult even for billers and coders to interpret, according to the researchers.

Codes often do not map one-to-one or one-to-many, says Andrew Boyd, UIC assistant professor in biomedical and health information sciences and one of the study's co-authors. A cluster of codes might map to several ICD-10 codes, which might then map back to different ICD-9 codes, he said.

In the study, the researchers 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.

They also looked at ICD-9-CM outpatient diagnosis codes and associated billing charges used by University of Illinois Cancer Center physicians from 2010 to 2012 and selected the 100 most-used codes.

Using a web-based tool developed at UIC, the researchers input the ICD-9 codes and translated them into ICD-10 codes. They looked at whether the translation made sense; whether a loss of clinical information occurred; and whether a loss of information had financial implications.

"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," said Dr. Neeta Venepalli, UIC assistant professor of hematology/oncology and first author of the study.

In looking at the financial implications, the researchers found that 39 ICD-9-CM codes with information loss accounted for 2.9 percent of total Medicaid reimbursements and 5.3 percent of UI Cancer Center billing charges.

The report highlights the 39 codes "to help identify that there might be trouble with reimbursement for these codes," said Boyd.


Story Source:

The above story is based on materials provided by University of Illinois at Chicago. Note: Materials may be edited for content and length.


Journal Reference:

  1. Neeta K. Venepalli, Yusuf Qamruzzaman, Jianrong “John” Li, Yves A. Lussier, Andrew D. Boyd. Identifying Clinically Disruptive International Classification of Diseases 10th Revision Clinical Modification Conversions to Mitigate Financial Costs Using an Online Tool. Journal of Oncology Practice, March 2014 DOI: 10.1200/JOP.2013.001156

Cite This Page:

University of Illinois at Chicago. "Transition to ICD-10 may cause information, financial losses for providers." ScienceDaily. ScienceDaily, 12 March 2014. <www.sciencedaily.com/releases/2014/03/140312132854.htm>.
University of Illinois at Chicago. (2014, March 12). Transition to ICD-10 may cause information, financial losses for providers. ScienceDaily. Retrieved April 18, 2015 from www.sciencedaily.com/releases/2014/03/140312132854.htm
University of Illinois at Chicago. "Transition to ICD-10 may cause information, financial losses for providers." ScienceDaily. www.sciencedaily.com/releases/2014/03/140312132854.htm (accessed April 18, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Saturday, April 18, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Our Love Of Puppy Dog Eyes Explained By Science

Our Love Of Puppy Dog Eyes Explained By Science

Newsy (Apr. 17, 2015) Researchers found a spike in oxytocin occurs in both humans and dogs when they gaze into each other&apos;s eyes. Video provided by Newsy
Powered by NewsLook.com
Dr. Oz Under Fire For 'Quack Treatments' Yet Again

Dr. Oz Under Fire For 'Quack Treatments' Yet Again

Newsy (Apr. 17, 2015) Ten doctors signed a letter urging Columbia University to drop Dr. Oz as vice chair of its department of surgery, saying he plugs "quack" treatments. Video provided by Newsy
Powered by NewsLook.com
Scientists Find Link Between Gestational Diabetes And Autism

Scientists Find Link Between Gestational Diabetes And Autism

Newsy (Apr. 17, 2015) Researchers who analyzed data from over 300,000 kids and their mothers say they&apos;ve found a link between gestational diabetes and autism. Video provided by Newsy
Powered by NewsLook.com
Video Messages Help Reassure Dementia Patients

Video Messages Help Reassure Dementia Patients

AP (Apr. 17, 2015) Family members are prerecording messages as part of a unique pilot program at the Hebrew Home in New York. The videos are trying to help victims of Alzheimer&apos;s disease and other forms of dementia break through the morning fog of forgetfulness. (April 17) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins