Study: ICD-10 Transition Costly for Pediatricians | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Study: ICD-10 Transition Costly for Pediatricians

June 3, 2014
by Gabriel Perna
| Reprints

A new study reveals that pediatricians may lose money and clinical information thanks to the ICD-10 transition.

The study, from researchers at the University of Illinois at Chicago (UIC), looked at ICD-9 to ICD-10 mappings for pediatrics and which current codes could potentially cause financial or information loss if they were mapped incorrectly to ICD-10 codes. Using the 2010 Illinois Medicaid data to identify ICD-9-CM codes for pediatric patients treated at the University of Illinois Hospital & Health Sciences System, the researchers determined 2,708 diagnosis codes used by pediatricians in 174,500 patient encounters for a total Medicaid payment of $12,298,520.

Using a self-developed web-based tool, the researchers mapped those codes to ICD-10 codes and then categorized them by the complexity of the transition--from easy to hard. They found that 26 percent of pediatric ICD-9 codes have complex mapping to ICD-10, representing 21 percent of Illinois Medicaid pediatric patient encounters and 16 percent of total reimbursements. As an example, the researchers pointed out how the ICD-9 code V38.30 "Twin, mate stillborn" maps to ICD-10 code Z38.30 "Twin liveborn."

"Many pediatric practices, perhaps more than other medical fields, practice on a narrow financial margin and are often reimbursed at lower rates than other specialties, particularly by Medicaid," Rachel Caskey, M.D., UIC assistant professor of pediatrics and co-author of the study, said in a statement.

This is not the first study from UIC on ICD-10 transition, and specifically the financial and data loss that comes from incorrect mappings. As noted in previous studies by UIC, an incorrect mapping could mean practices may not get reimbursed and clinical information could be lost.

Some studies estimate that implementation of ICD-10 will cost between $83,000 and $2 million per practice - See more at: http://news.uic.edu/pediatricians-transitioning-to-icd-10-may-experience...

This study was published in Pediatrics.

“Many pediatric practices, perhaps more than other medical fields, practice on a narrow financial margin and are often reimbursed at lower rates than other specialties, particularly by Medicaid,” said Dr. Rachel Caskey, UIC assistant professor of pediatrics and co-author of the study. - See more at: http://news.uic.edu/pediatricians-transitioning-to-icd-10-may-experience...
University of Illinois at Chicago

University of Illinois at Chicago

 

University of Illinois at Chicago
University of Illinois at Chicago
University of Illinois at Chicago

Read the source article at UIC News Center

Get the latest information on ICD10 and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More

Topics

News

HealthlinkNY’s Galanis to Step Down as CEO

Christina Galanis, who has served as president and CEO of HealthlinkNY for the past 13 years, will leave her position at the end of the year.

Email-Related Cyber Attacks a Top Concern for Providers

U.S. healthcare providers overwhelmingly rank email as the top source of a potential data breach, according to new research from email and data security company Mimecast and conducted by HIMSS Analytics.

Former Health IT Head in San Diego County Charged with Defrauding Provider out of $800K

The ex-health IT director at North County Health Services, a San Diego County-based healthcare service provider, has been charged with spearheading fraudulent operations that cost the organization $800,000.

Allscripts Touts 1 Billion API Shares in 2017

Officials from Chicago-based health IT vendor Allscripts have attested that the company has reached a new milestone— one billion application programming interface (API) data exchange transactions in 2017.

Dignity Health, CHI Merging to Form New Catholic Health System

Catholic Health Initiatives (CHI), based in Englewood, Colorado, and San Francisco-based Dignity Health officially announced they are merging and have signed a definitive agreement to combine ministries and create a new, nonprofit Catholic health system.

HHS Announces Winning Solutions in Opioid Code-a-Thon

The U.S. Department of Health and Human Services (HHS) hosted this week a first-of-its-kind two-day Code-a-Thon to use data and technology to develop new solutions to address the opioid epidemic.