The benefits of the new classification system to both the insurance carrier and the medical provider have been proven and documented. The benefits to the provider, for example, include:

Decreased administrative burden. Provider staff will spend less time making copies and responding to requests for additional documentation.
The new codes are distinct with a focus on outcomes they provide a key concept in coordination of care.

Perhaps the biggest challenge with ICD-10 implementation is the coordination of all aspects of readiness. ICD-10 touches many areas of a provider and carrier business, and the impact cannot be minimized. To date, creating a program around the multiple areas that use the code sets and then building an effective program to ensure compliance have been the most valuable aspects of successful execution. Providers may experience nevertheless experience issues in several areas during the implementation process. Fortunately such issues can be mitigated with proper management, including:

Payers may delay payments because of readiness issues. Carriers need to be able to handle the costs associated with changes in accounts receivable timelines.
Providers will most certainly take a productivity hit. This has been proven in many studies, as well as while observing countries such as Canada in its implementation experience. The effect can, however, be lowered with proper training, practice, implementation of electronic health records, and the use of computer-assisted coding software.
ICD-10 code sets require knowledge to operate and apply successfully. Providers may encounter a mixed bag of frustration and enthusiasm on the part of office staff.
Office and hospital staff will also likely be addressing issues stemming from the payer failing to pay bills properly. These issues can definitely be morale changers.

Of course, carriers will not need all individuals who encounter the new sets to be experts in coding, although it doesn't hurt to retain a few key individuals with that very skill set. Managers will need to ensure their staff understands how the code set is used. Some issues that P&C carriers specifically will need to resolve are:

Operational impact to medical bill review may occur because ICD-10 code sets are so detailed. As a result, there is opportunity for either more straight-through processing or to investigate more claims based on specific criteria.
Carriers will receive code sets even after the implementation date of October 1, 2014. This may happen because the provider is not a covered entity under HIPAA, or if it has an exemption. Either way, carriers need to be versatile enough to handle both situations and pay bills accordingly.
Did you miss an internal area that uses ICD-10 during your assessment phase? If so, then just make the fix. It is also important to establish the expectation that there may be unknowns in order to minimize frustration within your teams.
Carriers will need to understand any gaps in bill review systems after ICD-10 code set implementation. This is because some edits in bill review systems were done because ICD-9 was so non-specific that it created more work to review the care.

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