After ICD-10, will coders ever regain ICD-9 efficiency levels?

Carl Natale
by Carl Natale

If anyone is suggesting that ICD-10 will not create a productivity drop in the days after compliance, they must be practicing silent protest. Most experts agree that come the flip-switch October 1, 2013 compliance deadline even seasoned, well-trained coders will take longer with the ICD-10 than they did with ICD-9. The overarching question is whether or not coders will master ICD-10 and, in so doing, resume ICD-9-era productivity?

An expanding camp of healthcare experts and industry bodies is answering that question with a definitive “No!” The AAPC (American Academy of Professional Coders), for instance, posted an article last week, ICD-10 Impact on Productivity, explaining the causes of lower productivity, and saying that “productivity will not return to normal upon implementation. There will be a delay as we assess how the payers interpret the new coding system.”

[Related: Will ICD-10 spark coder chaos? See also: HIMSS11 takeaway: ICD-10 tricky, and just a start.]

Why? Greater specificity, new documentation, an increase from five to seven digits, are just some of the reasons.

“There will be a learning curve that comes with ICD-10; the codes are very different, the guidelines have changed in some areas, and we are going to be communicating with physicians more closely to make sure all the necessary information is available,” the AAPC states in its article. “Initially, we will have to learn all the new guidelines and coding processes. Today, the codes are still considered 'unstable' and are subject to change prior to implementation.”

Last October, Cynthia Grant, director of Canadian consultancy Courtyard Group, said that productivity in Canada, which has already adopted ICD-10, never bounced back to ICD-9 levels.

There's simply no way around the time it takes to use more codes and more digits, to achieve that greater granularity.

AAPC's Reid says that success rate of ICD-10 – including coder productivity levels – will vary based on how providers plan for and ultimately harness the new codes.

“I think there are so many unknown factors there,” Reid adds in an email to ICD10Watch. “The sooner people begin the preparation process and start changing the way they document and code, the more quickly they will 'bounce back' from the changes. I do expect that the U.S. will bounce back from the changes, but how long that will take is yet to be seen…”