IMPACT of ICD-10 Upon Reimbursement

Is anyone aware of any published 'white paper', website, or other source document speaking to the impact of ICD-10 upon reimbursement? I am not referring to the known impact upon billing (lessened cash flow) due to coder productivity, rather, I am referring to other projected consequences of reimbursement - increases or decreases in projected reimbursement resulting directly from the conversion from ICD-9 to ICD-10.

Thanks, Paul EVans

Comments

  • edited May 2016
    Paul,

    CMS has an article that discussed the impact on DRGs.


    Impact of the Transition to ICD-10 on Medicare Inpatient Hospital Payments

    Abstract: On October 1, 2013 the reporting of diagnoses and procedures in the U.S. will transition from the clinical modification of the ninth revision of the International Classification of Diseases (ICD-9-CM) to the tenth revision (ICD-10). The impact of conversion to ICD-10 on Medicare MS-DRG payments to hospitals was estimated using 2009 Medicare data. A minimal hospital payment increase of 0.05 percent was found using the ICD-10 version of MS-DRGs. In contrast, a modest hospital payment decrease of 0.38 percent was found when ICD-10 data was mapped backed to ICD-9-CM and the ICD-9-CM version of MS-DRGs was used. Key words: ICD-10, Mapping, Payment Impact, MS-DRGs
    SSSince 1979.

    http://www.cms.gov/Medicare/Coding/ICD10/Downloads/MsdrgConversion.zip

    Dorie Douthit RHIT,CCS
    AHIMA-Approved ICD-10-CM/PCS Trainer
    ddouthit@stmarysathens.org


  • Thanks, Dorie!

    Paul Evans, RHIA, CCS, CCS-P, CCDS
     
    Manager, Regional Clinical Documentation & Coding Integrity
    Sutter West Bay
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell:  415.637.9002
    Fax:  415.600.1325
    Ofc:  415.600.3739
    evanspx@sutterhealth.org



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