Conversion from ICD-9 to ICD-10 Coding Denials and Charges, but …

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The conversion to ICD-10 from ICD-9 coding has led to significant increases in coding-related denials, denied charges, and the use of unspecified codes, according to an analysis involving >44,500 billable patient encounters. Still, overall revenue and clinical volume were not impacted. 

Investigators compared billing and coding data from an academic ophthalmology practice for 1-year periods before and after conversion from ICD-9 to ICD-10.  Among the results: 

  • Conversion had no impact on payments per visit, relative value units per visit, mean volume of visits, or percentage of high-level visits. 
  • Coding-related denials increased from 0.98 to 1.84 per every 100 visits.
  • Denied charges increased from $307 to $661. 
  • The monthly percentage of unspecified codes used increased from 26% to 35%.

Hellman J, Lim M, Leung K, Blount C, Yiu G.  The impact of conversion to International Classification of Diseases, 10th revision (ICD-10) on an academic ophthalmology practice. Clin Ophthalmol. 2018;12:949-956. doi: 10.2147/OPTH.S161742.    

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