Is there a perfect storm coming in the form of ICD-10 coding, ACA reforms, and Meaningful Use? Will some doctors go out of business because of a failure to prepare for the ICD-10 changeover?
All of these possibilities were explored in a New York Times article last week. The article starts out playfully, noting that ICD-10 includes medical billing codes for a person who drowned from jumping off burning water skis, someone who was injured in a spacecraft, and someone who was attacked by an Orca whale.
But the article is notable for several reasons. First, it shines a spotlight on the massive changes occurring in healthcare, many simultaneously, bringing them into focus for the general public. Second, it has yet another definitive statement about the October 1 deadline—a CMS spokeswoman said the agency was “committed to implementing ICD-10 on Oct. 1, 2014, and that will not change.”
Third, it contains perspectives from several industry viewpoints:
- “If you don’t code properly, you don’t get paid. It’s going to put a lot of doctors out of business,” Dr. W. Jeff Terry, urologist, Mobile, Ala.
- “Failure to appropriately test ICD-10 could result in operational problems similar to what [HHS] experienced with the rollout of HealthCare.gov,” Medical Group Management Association.
- The need to prepare for ICD-10 and the Affordable Care Act and to achieve so-called meaningful use of electronic health records all at once could overwhelm computer staffs throughout the healthcare industry, Dr. John D. Halamka, CIO, Beth Israel Deaconess Medical Center, Boston
- “It doesn’t matter what deadline we get. We’ll find a way not to meet it,” Rhonda Buckholtz, vice president for ICD-10 education and training at the American Academy of Professional Coders.
In a previous post, we’ve discussed how the large majority of physicians are overwhelmed by the all changes incoming for ICD-10. Of course, the ICD-10 picture is not entirely gloomy. One notable bright spot is Christopher Chute, professor of biomedical informatics at Mayo Clinic, who told the Times, “It’s not going to be a shock to the industry to confront this. We’ve literally had seven or eight years to anticipate it.”
Lee Browder, national director of the Professional Association of Healthcare Coding Specialists, is also optimistic, saying the transition should not be too hard for coders. He likened it to the introduction of longer ZIP codes—there are now more codes, but the concept is the same.
However, reporter Andrew Pollack includes the sticking point that all ICD-10 discussions get around to eventually. “The transition could be tougher for doctors, because they will have to be more specific in describing a patient’s condition,” he writes. We have talked about different ways to avoid ICD-10 challenges and to be best prepared for the switchover.
As we enter into another year of using ICD-10 healthcare codes, there have been new additions to the list of existing codes. These changes come in the wake of the coronavirus-19 and CDC has announced that these codes will take effect beginning the new year, invalidating previous codes used for reporting.
These new additions include:
- Z11.52 – Encounter for screening for COVID-19
- Z20.822 – Contact and potential exposure to COVID-19
- Z86.16 – Personal history of COVID-19
- M35.81 – Multisystem inflammatory syndrome
- M35.89 – Issue of systemic involvement of connective tissue
- J12.82 – Pneumonia due to COVID-19
Last Updated on January 11, 2021