Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
J Am Coll Radiol. 2018 Jan;15(1 Pt A):69-74. doi: 10.1016/j.jacr.2017.08.013. Epub 2017 Oct 24.
The 2015 conversion of the International Classification of Diseases (ICD) system from the ninth revision (ICD-9) to the 10th revision (ICD-10) was widely projected to adversely impact physician practices. We aimed to assess code conversion impact factor (CCIF) projections and revenue delay impact to help radiology groups better prepare for eventual conversion to ICD, 11th revision (ICD-11).
Studying 673,600 claims for 179 radiologists for the first year after ICD-10's implementation, we identified primary ICD-10 codes for the top 90th percentile of all examinations for the entire enterprise and each subspecialty division. Using established methodology, we calculated CCIFs (actual ICD-10 codes ÷ prior ICD-9 codes). To assess ICD-10's impact on cash flow, average monthly days in accounts receivable status was compared for the 12 months before and after conversion.
Of all 69,823 ICD-10 codes, only 7,075 were used to report primary diagnoses across the entire practice, and just 562 were used to report 90% of all claims, compared with 348 under ICD-9. This translates to an overall CCIF of 1.6 for the department (far less than the literature-predicted 6). By subspecialty division, CCIFs ranged from 0.7 (breast) to 3.5 (musculoskeletal). Monthly average days in accounts receivable for the 12 months before and after ICD-10 conversion did not increase.
The operational impact of the ICD-10 transition on radiology practices appears far less than anticipated with respect to both CCIF and delays in cash flow. Predictive models should be refined to help practices better prepare for ICD-11.
2015 年，国际疾病分类（ICD）系统从第九版（ICD-9）转换为第十版（ICD-10），这被广泛预测将对医生的实践产生不利影响。我们旨在评估代码转换影响因素（CCIF）预测和收入延迟影响，以帮助放射科团体更好地为最终向 ICD-11 版（ICD-11）的转换做准备。
我们对 ICD-10 实施后的第一年的 179 位放射科医生的 673600 项索赔进行了研究，为整个企业和每个亚专科部门的所有检查的前 90%确定了主要 ICD-10 代码。使用既定的方法，我们计算了 CCIF（实际 ICD-10 代码÷前 ICD-9 代码）。为了评估 ICD-10 对现金流的影响，我们比较了转换前后 12 个月的应收账款平均每月天数。
在所有 69823 个 ICD-10 代码中，只有 7075 个用于报告整个实践中的主要诊断，只有 562 个用于报告 90%的索赔，而 ICD-9 则只有 348 个。这相当于该部门的整体 CCIF 为 1.6（远低于文献预测的 6）。按亚专科划分，CCIF 范围从 0.7（乳房）到 3.5（肌肉骨骼）。ICD-10 转换前后 12 个月的应收账款平均每月天数没有增加。
就 CCIF 和现金流延迟而言，放射科实践中 ICD-10 过渡的运营影响似乎远低于预期。预测模型应加以完善，以帮助实践更好地为 ICD-11 做准备。
