The Costs and Benefits of Moving to the ICD-10 Code Sets
Published Jun 3, 2004
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In spring 2003, the National Committee on Vital and Health Statistics asked RAND to conduct a study of the benefits and costs of switching from ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) codes for diagnoses and procedures to two code sets based on the 10th revision of ICD: ICD-10-CM and ICD-10-PCS. This technical report presents RAND’s first-order analysis of the benefits and costs of mandating such a switch (either simultaneously or sequentially). The author estimates a dollar range for (1) costs in the areas of additional training for coders, the impact on productivity, and system changes, and (2) benefits in the areas of more-accurate payments for new procedures; fewer miscoded, rejected, and improper reimbursement claims; better understanding of the value of new procedures; improved disease management; and better understanding of health care outcomes. He concludes that that switching to both ICD-10-CM and ICD-10-PCS is likely to generate more benefits than costs but that the switch, if it takes place, should be simultaneous and not sequential.