ICD-9 to ICD-10, The Journey and the Cost By: Bill W. Childs

1. ICD-9 to ICD-10, The Journey and the Cost By: Bill W. Childs Many Authorities on the subject say that ICD-9 to ICD-10 is as onerous as Y2K! (Burdensome, Arduous, Heavy, Difficult, Tiring, Time-Consuming, Tedious) and I would add EXPENSIVE!!!(Burdensome, Arduous, Heavy, Difficult, Tiring, Time-Consuming, Tedious) and I would add EXPENSIVE!!!

2. Information Explosion Information Explosion Time Line Number of Years 4000 BC to 1800 AD 5,800 years 1800 AD to 1900 AD 100 1900 AD to 1945 AD 45 1945 AD to 1960 AD 15 1960 AD to 1970 AD 10 1970 AD to 1975 AD 5 1976 AD to 2010AD 1 This is a 6000 year time line of information explosion (No one can get a handle on how fast information is coming at us.(Apple iphone 4This is a 6000 year time line of information explosion (No one can get a handle on how fast information is coming at us.(Apple iphone 4

3. Information Explosion #2 Storage Capacity Costs Bytes Dollars Megabytes Hundreds of Dollars Gigabytes Thousands of Dollars Terabytes Millions of Dollars Petabytes Trillions of Dollars Exabytes Quadrillions of $$$ Zettabytes Quintillions of $$$ Yottabytes Sextillions of $$$$

4. Technology Explosions Medicine Clinical / Medical Information Systems High Speed Internets and Web Pages Cell Phones Storage and instant retrievals Standards Invasive and Non-Invasive Patient Monitoring

5. Quality Improvement via I.S. Continuous Monitoring of Patients V/S Temperature, Pulse, Respiration, BP Blood Sugars, Respiratory rates Electrolyte Balances INR�s, Oxygen saturation, Heart rate Heart Valve Performance This list goes on and on

6. ICD-9 to ICD-10 Code Explosion Twice the number of diagnosis codes Twenty times the number for injuries Fifty times the number for New Medical Procedures These of course are all updated once a year on October 1st. October 1st, HUMM, that�s today, darn my presentation is old information isn�t it?October 1st, HUMM, that�s today, darn my presentation is old information isn�t it?

7. Time Lines On October 1,2013 all claims processing must be transitioned to ICD-10 codes. Beginning January 1, 2011 CMS will begin accepting ICD-10 Codes. ICD-11 will be accepted in 2011 and must be implemented by 2015

8. COST? Nationally between One and Two Billion dollars spread over Hospitals Physician Offices Payers Government Vendors of Systems Rand Corporation $425 Million & $1.2 Billion, Hay Corporation $2 Billion to $8.3 BillionRand Corporation $425 Million & $1.2 Billion, Hay Corporation $2 Billion to $8.3 Billion

9. Cost Entities Management & Building a plan Discovery Phase Contract Renegotiation between ICD-9 and ICD-10 with 3rd Party Payers Training, Training & Training New Procedures Systems changes to accommodate logic and new procedures (more & field length) Many entities that I know are planning this to be a 2 to 3 year effort.Many entities that I know are planning this to be a 2 to 3 year effort.

10. Estimated Cost by Provider Hospitals 400+ Beds $500K to $2 Million 200 to 400 Beds $250K to $1 Million 100 to 200 Beds $150K to $500 K < 100 Beds $35K to $150K In my opinion Hospitals will never get this done for less than $200,000.In my opinion Hospitals will never get this done for less than $200,000.

11. Estimated Costs by Physicians Size of Practice or Clinic Cost 21 Plus $50,000 to $100,000 11 to 20 $20,000 to $40,000 6 to 10 $10,000 to $20,000 3 to 5 $5,000 to $10,000 1 to 2 $2000 to $8,000 In my opinion Physician offices will never get this done for less than $10,000 and maybe $20,000 is the rock bottom cost. In my opinion Physician offices will never get this done for less than $10,000 and maybe $20,000 is the rock bottom cost.

12. Potential Benefits More accurate benefits for new procedures. Fewer miscoded, rejected and improper reimbursement claims. Better understanding of the value of new procedures Improved understanding and classification of disease management. Better understanding of Healthcare outcomes. As articulated by CMS and other stataticiansAs articulated by CMS and other stataticians

13. The End! Lost Productivity? If ICD-10 not ready or wrong there will be no reimbursement from any 3rd party payers. So much to do so little time: Meaningful Use HIPAA 5010 ARRA ICD-10 We can not get it all done in the time allotted with the money we have or do not have as the case may be!We can not get it all done in the time allotted with the money we have or do not have as the case may be!