Recent implementation of ICD-10
Joshua Davidson, MD, MPH is a Lead Clinician and Allergy/Immunology Specialist with HealthCare Partners Medical Group in Redondo Beach, Calif. He graduated from the University of California, Los Angeles David Geffen School of Medicine in 2003 and completed his Allergy/Immunology fellowship training at National Jewish Health in Denver, the No. 1 respiratory hospital in the country.
We recently Asked Dr. Davidson for his feedback on the implementation of ICD-10. Here’s what he had to say:
It’s been several months since ICD-10 was implemented. Has it been effective?
Yes, I believe it has been effective.
Has the transition to ICD-10 been more or less turbulent than you expected? Why?
It has been less turbulent that we expected, largely due to the use of AllScripts as our EHR/EMR program. ICD-10 codes were pre-mapped to existing ICD-9 codes, and this made a tremendous difference.
Do you have any stories about your transition to ICD-10? (Billing issues, patient issues, etc.)
I have run into some issues with inappropriate mapping of ICD-9 and ICD-10 codes, e.g. a lack of specificity to justify a medication. However, these issues are easily remedied and I have not experienced difficulties getting treatment to patients.
Can you list one advantage and one disadvantage of ICD-10 so far?
Advantage: Increased specificity of diagnoses, which is helpful in terms of describing an particular concern.
Disadvantage: There are some superfluous and/or eccentric diagnosis included in ICD-10 – diagnoses that would never arise.
What insurance payers seem to be the most prepared for ICD-10?
Anthem Blue Cross/Blue Shield and Aetna have been the most prepared.
If you could say anything to Medicare, what would you say?
Be prepared for the post-August 2016 world, when submission of ICD-9 codes will no longer apply. I think there will be a backlog of charges that will accrue.
Are there any procedures you can bill under ICD-10 that you couldn’t bill under ICD-9?
No, not at this time.
How has your medical practice trained staff for ICD-10? Do you have any lessons you can share with our readers?
Yes, our staff viewed webinars and training programs designed to prepare them for the transition. I think the best lesson is to work hard up front to map the most common ICD-9 codes to new ICD-10 codes, thereby minimizing the stress of the transition. Over time the ICD-10 codes will become the standard numbers we all memorize for common conditions.
Does ICD-10 ultimately benefit the patient? Why or why not?
I do think it benefits the patient, as there is value in greater specificity of diagnoses. This will aid patient care as a patient moves between providers, carrying these more specific diagnostic codes with them.
In the end, do you think ICD-10 will be an improvement for your practice? Why or why not?
I do think so, particularly when it comes to HCC coding/higher reimbursement rates from Medicare. If we do the work to maximize our coding specificity, we will reap the financial benefits, and patient care will improve as well.
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Last Updated on April 1, 2016