Post-Implementation Cost-Analysis of the ICD-10-CM Transition on Small andMedium-Sized Medical Practices

Introduction: On October 1, 2015, the United States made a major transition in its medical billing and coding system, by switching from ICD-9-CM to ICD-10-CM. Several cost-analysis studies have attempted to estimate the eventual impact of the ICD-10-CM transition on medical practices, but all were completed prior to the actual transition deadline. Our study seeks to assess the post-implementation financial impact of the transition on small and medium medical practices which used a set of non-profit resources for their implementation. Methods: 6,000 medical practices were randomly selected from the approximately 70,000 user database of a non-profit ICD-10 provider and emailed a seven question survey. 419 practices completed the full survey (8.5% response rate), providing practice demographics, as well as estimates for the hours spent and cost accrued on the implementation. Results: Based on the reported data, the average total explicit cost of the ICD- 10-CM implementation was $1,206 for small medical practices and $2,462 for medium medical practices. The average total number of staff hours spent was 61.2 hours for small practices and 139 hours for medium-sized practices. The average total number of physician hours spent was 35.6 hours and 75.1 hours, respectively. Discussion: The total average cost of the ICD-10-CM implementation was calculated to be between $6,748 to $9,564 for a small medical practice and between $14,577 to $23,062 for a medium-sized medical practice. The results of this study suggest that for practices which used a set of free online resources, the eventual financial impact of the ICD-10-CM transition was less than predicted by the landmark Nachimson report for the American Medical Association (AMA), but greater than the study by Kravis et al (3M).