ICD-10 Costs Are Much Higher Than Previously Estimated


Opponents of upgrades to the new ICD-10, which include the likes of the American Medical Association, has yet another reason to offer criticism. It seems that the costs associated with transitioning to the new coding system may be even higher than what was previously estimated by medical billing experts.

A new report, which was funded by the American Medical Association holds that the initial figures projected for the costs of switching over to the new codes (which, per the CMS, will happen in October of this year), were calculated in 2008, prior to there being any access to actual practical knowledge regarding the true costs associated with the codes.

Dramatic Uptick In Costs From Previous Assessment

Original estimates around the costs associated with ICD-10 projected that the codes would bring about $83,000 in costs for small practices, $290,000 for medium sized practices, and $2.7 million dollars for large practices.

New figures suggest that the true costs of implementing codes may be as high as $226,000 for small practices, $824,000 for medium sized practices, and $8 million for large practices. This huge jump in actual costs has helped to fuel what has already been a relatively controversial subject in the medical community.

Biggests Cost Increases Coming From Coding Software

It seems that the practices poised to be hit the hardest by fees associated with the upgrade are those who anticipate having to spend heavily on software upgrades. The number of practices who will indeed have to invest in software upgrades in order to comply is as high as ⅔ of all practices.

The ⅓ of practices that are not likely to face fees associated with software upgrades are generally those who carry contracts with software providers that include provisions to keep all software up to date. Often these contracts carry high costs in and of themselves, so even practices that will not incur as high of additional fees will have costs associated with software and software maintenance.

Estimated Costs Take Into Account a Number of Elements

The estimated costs of the new coding system were determined based on conversations with members of the medical community from several sectors. Investigators interviewed vendors, consultants, and representatives from a wide variety of practices. It seems that implementing new codes will be costly from both a fiscal and time management standpoint because of the degree of changes that must be made in order for the upgrade to be successful.

Practices will have to change not only the way in which they code and bill, but also their practice management systems. Further challenges will be faced by practices who have not transitioned to an EHR, as transitioning into an EHR is a requirement for use of new coding and billing procedures. The cost estimates generated by contractors also took into account costs associated with education and training on the new systems and software.

Many Practices Unprepared For Upgrade

The fast approaching October 2014 deadline for switching to ICD-10 may be highly unrealistic for many practices. A recent study released by the MGMA has revealed that only 9.4% of practices are in fact prepared for adoption of the ICD-10 codes, and as many as 34% of practices report that they have not begun preparations for transitioning at all.

Many opponents of the codes argue that small practices will be very hard hit by the costs associated with adoption and may even be forced into downsizing or total closure. The American Medical Association continues to be very vocal in its opposition, and has even launched a Twitter campaign under the hashtag #StopICD10.

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