Challenges and rewards

As with any large-scale change, the move to ICD-10 coding will create some disruptions in routine as it is implemented throughout the hospital system. As the points below illustrate, however, the changes will also bring benefits, the coding will become routine with repeated use, and Upstate is committed to helping make the changeover as seamless as possible.

The Challenges
  • Learning the new system, which has many times more codes than ICD-9, in order to provide proper documentation.
  • Health care providers will have to spend more time entering codes into medical records, especially as they are getting used to the changes.
  • Payments to the hospital could be delayed or refused if records are not properly entered.
  • Nurses and coders will depend on providers properly filling out forms in order for their work to proceed smoothly.
The Rewards
  • The new system provides specific, thorough descriptions of patients' conditions and procedures.
  • Data collected under the new system will allow for a high level of medical research and public health analysis, and the standardization will allow comparisons of U.S. data with that of other advanced countries, who have already adopted ICD-10.
  • Much of the coding is intuitive, and providers who already provide thorough documentation will likely have the fewest problems adjusting.
  • ICD-10 allows appropriate payments based on sickness levels (morbidity), improved outcomes from population analysis and better targeting of resources to diseases.
  • Providers affiliated with a hospital will have a much easier time and institutional support than will providers who are on their own. Upstate has a training program in place and a telephone help line, and each clinical area should have a designated person to answer questions.
  • One incentive for the hospital is financial. Typically, the sicker the patient and the more resources used, the payment must correspond to the level of care. Proper, specific coding will also support correct and uninterrupted payments to the hospital.
  • Another incentive for care providers is that physicians are increasingly evaluated on the quality of care they provide. ICD-10 will better reflect their patients' true conditions and the quality of care they receive.