It had been nearly a full two years since the mandated switch to ICD-10. Though the U.S. was one of the last countries in the world to leave behind the old ICD-9 system, many providers and coders alike clung to the old, familiar way of documenting patient illnesses and injuries. The change was frustrating for some practices and nearly debilitating for others, but as with all things, everyone was eventually able to adapt and in many cases even increase productivity. Though the official two-year statistics have yet to be released, data from earlier in the year shows just how much ICD-10 has already changed the healthcare industry for the better.
During the Q4 periods of 2014 (before ICD-10) and 2015 (during the initial ICD-10 grace period), the average time for a practice to process a claim was 25 days. Once the new system had settled in by Q4 of 2016, however, the time had dropped to just 13 days. A similar change occurred with the payer side of the equation, with average time dropping from 17 days down to 13 days as well. Overall, this cut the processing time for a claim nearly in half from 45 days down to 26.
More positive trends appeared in the area of claim denials. The denial rates in Q4 2014 and Q4 2015 were 15.4% and 15.5%, respectively, but by Q4 2016, they were down to 13.8%. While not as dramatic a change as the processing times, this improvement still suggests that ICD-10 is changing the coding and billing process for the better.
Finally, ICD-10 has sparked a positive trend for payment times. Previously, only about 60-65% of providers received reimbursement within the first 30 days of submitting a claim. Since ICD-10, however, that number has increased to over 70%. Better still, the amount of providers who had to wait 60 or more days for reimbursement has dwindled down from 12-15% to a mere 5%.
Though it is still relatively early in the process, the statistics suggest that ICD-10 has already been a major improvement for the healthcare industry. As more data continues to roll in, particularly after the official two-year mark, we will be able to see an even better snapshot of these changes.