ICD-10 educator Rhonda Buckholtz says the industry needs to calm down about ICD-10 so everyone can fully understand what really has to happen and begin to prepare in earnest.
"We've all heard horror stories about the ICD-10 implementation, and at a time when we have so many other competing initiatives it's hard to be able to think straight about something that's two years away," said Buckholtz, a certified professional coder and vice president of ICD-10 education and training at AAPC. "But what you read in the multitude of stories designed to shock and awe the industry are not always what they appear to be upon first glance."
She shared the top five reasons healthcare providers need not be afraid.
1. Costs won't skyrocket
"Realistically, it will not take most providers $100,000, $80,000, or even $50,000 to prepare for the ICD-10 transition. Unless they're purchasing an entire EMR system for the sole purpose of ICD-10, it's doubtful they will see those types of costs," said Buckholtz. With the implementation of 5010 earlier this year, most healthcare organizations have probably already purchased new technology. So, the next step is to work with vendors to determine how to get the new codes into an organization's systems, test the timeframes they will be available, figure out what the upgrades may cost and what additional training staff members may need. This will be the best way to determine budgets and prepare accordingly.
Reports of other countries productivity not returning or taking several years to do so after implementing ICD-10 shouldn't be used as a comparison. Other countries don't use the codes the same way the United States does, and in some cases went from DOS-based systems to EMRs, which caused big issues. "Organizations who've implemented EMRs know how workflow changes hinder productivity," said Buckholtz. "Unless a company is implementing an EMR at the same time as they're trying to use new codes – and you refuse to get prior training – you won't have productivity issues like other countries. Strategy counts here."
3. It won't change the way you practice medicine
"A diagnostic code is not capable of changing the way you treat patients," said Buckholtz. "You will have to analyze your current documentation habits, though, to make sure you're actually documenting the new concepts found in ICD-10." According to Buckholtz, some things will be simple – such as documenting whether an affected area was on the left or right side – and others may be more complicated. "At the end of the day, as long as you capture all of the elements that complete the clinical picture of a patient, you'll meet the requirements.” Readiness audits, Buckholtz said, will help to make sure your documentation is hearty enough to meet specificity, to meet other quality initiatives and mandates that are not tied to ICD-10, keep you in compliance and will make fewer productivity issues upon implementation.
4. Specificity of codes
Yes, there are codes for "walked into a lamppost" or "being burned by flaming water skis," but most healthcare organizations will never require the use of them. "Keep in mind, though, if you can tell a health plan the activity, location and work status of the patient when they were injured, chances are your claims can be automatically adjudicated with no additional record requests required, easing the administrative burdens that are normally required," said Buckholtz. Code specificity does help justify medical necessity and data tracking as well. At this time, however, it's unsure just how many payers will actually require this level of coding – most don't require the use of these codes under ICD-9 now.
5. Superbill alternatives
You depend on your ICD-9 superbill cheat sheet but it will have to go away because the top 50 codes for any given specialty under ICD-10 can range from two pages to eight pages. However, there are alternatives. "Instead, leave room to write the codes on the form. Put laminated cheat sheets or reference sheets in each exam room and simply refer to them when filling out your superbills," advises Buckholtz.