ICD-10Todd Jaffe M.D., is the president and owner of Brevard Pain Management in Melbourne, Fla. He received his undergraduate degree from the University of Miami and his medical degree from the Chicago Medical School. His internship, residency and fellowship in Anesthesiology and subspecialties were done at Bowman-Gray School of Medicine in North Carolina. Dr. Jaffe is board certified in Anesthesiology, Addiction Medicine and subspecialty certified in pain medicine through the American Board of Anesthesiology.
We recently asked him his thoughts on the recent transition to ICD-10. Here’s what he had to say:
 
It’s been seven months since ICD-10. Has it been effective?
If by effective you mean has it cost us money to implement and are we able to see less patients? Yes.
 
Has the transition to ICD-10 been more or less turbulent than you expected? Why?
It has been more turbulent as it still remains difficult to find the new codes quickly.
 
Do you have any stories about your transition to ICD-10? (Billing issues, patient issues, etc.)
We have converted but I had an epidural denied because the first diagnosis was the lumbar complaint, the second was the cervical complaint. The case evaluator would not accept the second diagnosis but kept saying that there was no reason to do a cervical epidural injection for a lumbar diagnosis.
 
Can you list one advantage and one disadvantage of ICD-10 so far?
I really see no advantages other than if we comply we are rewarded. As to disadvantages, conversion has cost me thousands in EMR cost and hundreds of thousands in lost patient revenue.
 
What insurance payers seem to be the most prepared for ICD-10?
Probably our local HMO is the most prepared, but even they underpay based on the diagnoses.
 
If you could say anything to Medicare, what would you say?
That Medicare needs to be scraped and start over covering only emergent and catastrophic care on a sliding scale.
 
Are there any procedures you can now bill under ICD-10 that you couldn’t bill under ICD-9?
No, and many we can’t bill now that we could bill before.
 
How has your medical practice trained staff for ICD-10? Do you have any lessons you can share with our readers?
We sent our biller off for a one week training course, our providers had a two-day update and some practice time.
 
Does ICD-10 ultimately benefit the patient? Why or why not?
While in an ideal world an ICD-10 like system that clearly defines a disease process in numbers and digits is superb, it is not practical in the world of open access medicine and poor reimbursements. We must find a way to fairly reimburse physicians so that a doctor makes more for saving a life than someone for throwing a football.
 
In the end, do you think ICD-10 will be an improvement for your practice? Why or why not?
ICD-10 has been the catalyst to put my practice up for sale. I will retire within five years rather than work to age 75 and ICD-10 and EHR’s are the reason.
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Last Updated on May 23, 2016