4 debatable points on the delay of ICD-10

By Michelle McNickle
08:58 AM

Fighting words were heard from both sides of the ICD-10 debate after the AMA called for a delay of the Oct. 1, 2013 deadline for conversion. LinkedIn and Twitter were bustling with yea or nay responses, which is why we asked Steve Sisko, IT consultant and avid ICD-10 blogger, and Rob Tennant, senior policy advisor at the MGMA, to weigh in.

1. The effect ICD-10 implementation will have on physician practices.  


It won’t be as bad as they think. According to Sisko, some practices will be burdened more than others with the switch to ICD-10. “But specialists only need to learn a subset [of codes],” he added. “They say ’70,000 ICD codes we’ll have to know,’ well, that’s BS because if you’re an orthopedic surgeon, there are subsets you don’t need to know; you don’t need to learn about other specialties’ codes.” He added, though, facilities will be impacted to a greater extent than professionals, due to the fact institutions have to collect, “Present on Admission and discharge diagnosis that professionals do not have to collect. They’ll have to lean on existing resources or hire external assistance.” 

However, he argues the transition is worth it, since, “ICD-10 will facilitate capture of accurate and complete documentation in a patient’s medical record. [It] will obviate the need for certain ‘procedure code modifiers,’ which can be confusing and lead to payment delays and increased administrative costs.” Additionally, according to Sisko, ICD-10 will enable practices to develop best practices as they get a better understanding of their costs and appropriate contracting rates. Not to mention, the transition will help practices develop enhanced care models based on comparative effectiveness research. “As time goes on, emerging CDI tools and EHR-functionality should make coding easier and more automated based on structured and semi-structured data contained in the EHR,” he added. 


It’s too much too soon.  Tennant argued the current financial environment doesn’t lend itself well to the implementation of ICD-10. “It’s impacting physician practices,” he said. “Patients have also lost their health insurance, so there’s two things with that. One is potentially fewer patients because they won’t come to the doctor’s office, and two it means when they come and they self pay, you’re shaking the money more and it goes to collections, which adds additional costs to practices.” Tennant added the looming Medicare cuts, which include more than a 27 percent reduction in Medicare payments, makes now a very uncertain time to look to ICD-10. “It’s not the best time, especially when we estimated it could be to the tune of $84,000 for a three-physician practice to move to ICD-10, not including any costs associated with 5010.” 

Barbara Aubrey

In our LinkedIn Group, ICD10 Watch, LinkedIn user Barbara Aubry echoed Tennant’s sentiments. “In Six Sigma, there is an acronym known as WIIFM, or what’s in it for me?” she wrote. “So far, I don’t think physicians believe there is much benefit to them or their patients to convert to ICD-10 – certainly not in the near term.” She added physicians are getting tired of “being pushed around by regulators and regulations.” Most, she wrote, did not go into medicine to be forced to run their business in a highly regulated environment. “Remember, many are small business owners, and they may have an entrepreneurial personality,” she wrote. “The changes are costing them time and money. I also think the AMA’s timing is quite exquisite, actually.” Twitter user @payerslayer agreed with both Aubry and Tennant and tweeted the transition affects the administrative costs of healthcare. “The U.S. cannot afford to make this change. Codes don’t cure patients,” she wrote. 

Continued on the next page.