Move to ICD-10 will hurt low-margin practices, study finds
Pediatricians and other low-margin practices could take a significant financial hit during the transition to ICD-10 procedural and diagnostic codes, according to a study in Pediatrics, the journal of the American Academy of Pediatrics.
The 68,000-code ICD-10 system is scheduled to replace the 14,000-code ICD-9 system Oct. 1, 2015. Researchers at the University of Illinois at Chicago used the CMS general equivalent mappings tool, or GEMs, to “translate” ICD-9 codes to their more granular ICD-10 counterparts. They calculated that, for pediatric patient encounters, payment and clinical data may get lost in about 8% of these translations.
One example of a mistranslation cited by the researchers described how the ICD-9 code for a stillborn twin mapped to the ICD-10 code for a live-born twin.
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