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How much will ICD-10 implementation really cost?

Converting to ICD-10 is the largest healthcare mandate in U.S. history, and it comes at a price. Early estimates suggest small physician practices could pay $83,290 for the transition.

But, as reported in EHR Intelligence, a recent study in the Journal of AHIMA paints a more hopeful picture. Based on new data about available solutions, authors estimate the cost for a typical small physician practice to be somewhere between $1,960 and $5,900.

So, depending on who you talk to, it can cost anywhere from $1,950 to $83,290. Anyone involved with ICD-10 implementations understands it’s the project’s complexity that makes it difficult to estimate cost.

Where are the biggest discrepancies? There are a few areas in which these studies differ:

1. Training

Researchers who expect lower costs maintain that there are more ICD-10 training options available to clinicians today, including more low-cost online options.

But practices will pay more for comprehensive and customized training options. There is a wide range of educational and consulting services to assess, plan, train and test for full ICD-10 compliance. It’s important to invest in training that is right for each practice, which varies widely in price structure.

Practices may also need to bolster training in areas that are not specific to ICD-10, but are necessary for a successful transition. For example, a practice may need additional training on Clinical Documentation Improvement (CDI) to ensure coders have the specification they will need for ICD-10

2. Vendor readiness

Earlier studies predicted more expenses for software upgrades. But today, more vendors are ready for ICD-10. A Workgroup for Electronic Data Interchange (WEDI) survey showed that two out of three vendors have ICD-10 products already available.

Allscripts products are ICD-10 ready (please see ICD-10 Compliance Status for Allscripts Solutions for details). For example, we’ve added more than 20,000 ICD-10 codes to our database and clinical decision support modules have all of the ICD-10 mandated clinical quality measures.* Clients already on the right versions may not incur any additional upgrade expense.

3. Process changes

The move to ICD-10 requires clinicians to change a lot of processes and behaviors. One example discussed in the study is the use of a superbill, which is an expensive option. The key is that with EHRs like Allscripts Professional EHRTM and embedded content, practices can remove superbills and their entire cost from the equation.

Vendors can and should conduct end-to-end software and clearinghouse testing. Allscripts Payerpath was selected and successfully participated in the first round of ICD-10 end-to-end testing with Medicare Administrative Contractors (MACs) and have requested to participate in the April and July testing as well. But practices will still need to test their internal processes, such as Evaluation & Management (E/M) coding, charge passing, claims submissions, posting remits, etc. These efforts will take time.

Beyond the cost of ICD-10 conversion, it’s also important to consider the value of it. Authors suggest that increased specificity of ICD-10 coding can enable better public health monitoring and quality of care. It’s too soon to tell exactly what value ICD-10 conversions will bring to small practices, though it’s clear that not being fully prepared with optimized systems and workflows will potentially be costly from a productivity and revenue standpoint.

To learn more about how Allscripts Consulting Services can assist you in preparing for the ICD-10 transition, please reach out to: consultingservices@allscripts.com.

To learn more about preparing for ICD-10 with minimal disruption, download a free white paper. Clients can also participate in the ICD-10 group forum on ClientConnect.

* For Allscripts clients who want to have ICD-10 support available and ready for use, make sure you are running on at least version 11.4 for Allscripts TouchWorks® EHR, version 13.0 SP1 for Allscripts Professional EHRTM, version 6.0 for SunriseTM from Allscripts, and version 10.4 for Allscripts Practice ManagementTM. A full list of Allscripts solution ICD-10 compliance status is available on ClientConnect.

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About the author

Matthew Fusan is a Strategic Sales Consultant at Allscripts. In this role he is focused on clients’ transition from fee-for-service to value-based care, develops solutions and provides strategic guidance to help clients succeed with alternative payment models and population health management. Prior to this role, Matthew was part of the Allscripts Regulatory Team providing guidance as Allscripts prepared products and services for new opportunities and challenges based on the transition to value-based care. Prior to Allscripts, Matthew held a variety of program management and delivery leadership positions at Blue Cross and Blue Shield of North Carolina and Highmark Blue Cross and Blue Shield. Matthew has more than 15 years of experience in the healthcare industry and holds a Bachelor of Science degree from Penn State University.

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