A Practice’s View of ICD-10

Posted on January 16, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In our recent article about AMA’s call to Halt ICD-10, we got a really interesting practice perspective on ICD-10 that I thought I’d share. The comments come from Sue Ann Jantz who works at a medical practice. Sue brings up some really interesting points that I think are on the minds of many practices and doctors. The final one about 3rd party payer systems is an important one.

In your recent article
The American Medical Association’s most recent call to halt implementation of ICD-10 codes brings to light an interesting angle to the coding story – one that I hadn’t recognized until I read up on just why the AMA has consistently made it known that the switch is a bad idea.

My two cent’s worth:
See, all of the coding changes are going to fall on the physicians — they won’t be able to pawn it off on anyone else, like a nurse or a coder/biller or an administrator. Remember, they do MEDICINE, not transcription, billing, personnel or business.

This is especially true of docs in large organizations such as hospitals and multispecialty clinics (MSC), who believe they have to do all the extra preventative care things because the government tells them to — not realizing that the incentive payment has some administrator licking their chops. As far as most Admins are concerned, getting the docs to do extra work doesn’t cost the hospital or MSC anything, so, why not?

Add to that the perfect storm that’s brewing: HITECH act —> electronic records and meaningful use (MU), ACA —> ACOs and reconfiguration of alliances, and then ICD-10 —-> total rearrangment of charting/documenting (plus the unknown).

And you are surprised there’s smoke coming out of the AMA’s ears? Personally, I am concerned there will be meltdown in the medical community. As far as most of them are concerned, this is all Obama’s fault, and they are furious and busy telling everyone who comes in that Obama is the devil. Granted, those that blame Obama are the one I’ve heard — so that’s probably a limited group in Kansas.

At a coding seminar recently, the presenter asked how many were going to get out before ICD-10 kicked in. Most of the room of 50 people raised their hands – about 80 percent. Further, they said their physicians were going to retire before that happened as well. ICD-10 is slated to go into effect Oct. 1, 2014. Everyone is supposed to be signed up for health insurance by Dec. 31, 2014, bringing anywhere from 15 million to 30 million people into the health care system looking for a provider.

Do you think this might be a problem?

That said, individually, all three of these things are long overdue. Had each been done when they needed to happen, we wouldn’t be in this fix now. Plus, ICD-10 will go into effect and a few months later, ICD-11 will be implemented everywhere else in the world — some think we should skip to ICD-11 … but we probably have enough on our plates at the moment.

Politically, Sebelius has to get this done before the end of Obama’s term. I hope it doesn’t crash us. I am working on it all as if it’s all going to happen. We are not part of an ACO, we probably won’t get to MU1 even though we are working on it because there isn’t enough money in it, although we did do the Adopt/Implement/Upgrade part of the HITECH act. So, that only leaves ICD-10. and I am working on our templates, those instruments of the devil by Sebelius’ standards. Without templates, we wouldn’t have a prayer.

And none of this addresses the 3rd party payer systems … which will probably crash if the early tests are indicative. That means we will not get paid. So I am stockpiling money for that time now.