ICD-10 consulting will shift in the next year from IT–centric to testing and revenue impacts. Many ICD-10–ready IT systems, providers and payers won’t know if they really have an end to end solution until they test using ICD-10 claims that are based on documentation that is coded in ICD-10.
ICD-10 revenue cycle management impacts for providers and ICD-10 based coverage determinations for health plans are only hypothetical until they are tested.
ICD-10 consulting efforts, in our experience are subject to the regulatory delays and human nature being what it is, there was a lull in activity after the delay. Now that we are within a year of the October 1, 2015 mandate, we expect to see more ICD-10 consulting work that is focused on ensuring end-to-end electronic claims processing actually works. The financial impact of ICD-10 is still under-estimated.
ICD-10 analytics in an ICD-10 risk assessment will be helpful to examine assumptions made in ICD-10 cross walks. ICD-10 data integrity will also be important to review. The ICD-10 implementation plan should include a review of ICD-10 CM diagnosis codes, which will be important for all care providers whether acute care or outpatient care. ICD-10 PCS procedure codes will be important for inpatient care. Testing of these assumptions is the only way to assure business continuity under ICD-10.
Below is an article I wrote on ICD-10 financial impacts: