Magazine article Medical Economics

ICD-10 May Financially Disrupt Primary Care, Pediatrics Practices

Magazine article Medical Economics

ICD-10 May Financially Disrupt Primary Care, Pediatrics Practices

Article excerpt

WHILE THE Centers for Medicare and Medicaid Services (CMS) boast of a successful ICD-10 testing week, a recent study shows that the switch to the new code set could be a significant financial disruption for narrowmargin primary care practices, especially those in pediatrics.

The study from researchers at the University of Illinois at Chicago (UIC), published in Pediatrics, the journal of the American Academy of Pediatrics, analyzed the impact of the ICD-10 transition on pediatric practices that operate on a low margin.

The researchers identified 2,708 ICD9 9 used by pediatricians in Illinois and compared them to 174,500 patient encounters at the University of Illinois Hospital and Health Sciences System. They mapped those codes from ICD-9 to ICD-10 and rated the transition from easy to complex or convoluted.

The researchers found that 26% of the transitions were complex, representing 23% of Illinois Medicaid pediatric encounters and 16% of reimbursements. The researchers concluded that financial disruptions MedicalEconomics. com

could occur in 8% of patient encounters.

"Many pediatric practices, perhaps more than other medical fields, practice on a narrow financial margin and are often reimbursed at lower rates than other specialties, particularly by Medicaid," said Rachel Caskey, MD, UIC assistant professor of pediatrics and coauthor of the study, in a written statement. …

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