ICD-10 myths debunked by Heather Bettridge, CPC, CPMA
F
aced with the Oct. 1, 2013, ICD- 10 implementation deadline, phy- sicians have a unique opportunity
to embrace the conversion and position themselves with an indisputable advan- tage — knowledge — before then. By beginning education now and
gradually incorporating changes, physi- cians can prepare their practices for the least amount of chaos and negative im- pact on the revenue cycle as possible. During their preparation, physicians
should avoid investing time or thought on these looming ICD-10 myths and mis- conceptions. Following are eight of the most wide- spread ICD-10 myths:
• The Centers for Medicare & Medic- aid Services (CMS) will postpone the date for ICD-10 implementation. The deadline for compliance with ICD-10 is Oct. 1, 2013. CMS has not indi- cated any plans to change this date or extend a grace period. (However, in November, the American Medical Association adopted a Texas Medical Association resolution directing AMA to ask CMS to stop implementation of ICD-10.) Do not report any ICD-9 codes for services provided on or af- ter Oct. 1, 2013. Any claims received with these old codes will not be paid.
• Physicians will have to document in a completely different way. Documenta- tion requirements for ICD-10 will vary from ICD-9; however, much of the detail necessary to code using the ICD-10 coding system is already be- ing documented. Documentation in- dicating the place and type of injury,
the sequencing of the encounter, etc., will now be required, not optional, as it is now using ICD-9. When docu- mentation does not support using a code with a higher level of specificity, physicians may continue to use “oth- er specified” (NEC) and “unspecified” (NOS) codes.
• The process of coding will be much more difficult. Because ICD-10 codes have greater specificity and a more logical code structure, finding the appropriate codes will be easier than before. CMS anticipates the devel- opment of robust coding tools that should ease the code selection pro- cess and make it faster.
• Other countries used ICD-10 for years, and it is already out of date. ICD-10 has been revised through the years to incorporate advancements in medi- cine and changes in technology. ICD- 10 already significantly exceeds ICD-9 in the number of available codes and disease classifications. While ICD-9 was nearing maximum capacity, ICD- 10 can add new codes through code structure improvements and the use of “placeholders.”
• Superbills will be cumbersome and nine pages long. Although one-page comprehensive superbills will become obsolete with the implementation of ICD-10, nine-page superbills would be impractical to use. As long as phy- sicians customize their superbills to their specialty and include the most frequently reported codes, superbills need not be any longer than before.
• Unnecessary testing will be performed to assign a code. Similar to coding in
the ICD-9 system, physicians may re- port codes for signs and symptoms if a diagnosis cannot be established during a patient encounter.
• ICD-10-PCS (Procedure Coding Sys- tem) will be used to code all services. Procedures and services will be coded according to the setting in which the encounter took place. ICD-10-PCS will be used to code inpatient/hospi- tal services. The Current Procedural Terminology (CPT) book will con- tinue to be used for outpatient proce- dures and services. ICD-10-PCS will not replace CPT codes.
• A practice must have an electronic medical record system to use ICD-10 codes. The ICD-10 coding system is not dependent on electronic hard- ware or software. All medical practic- es, whether using paper or electronic medical records, will be required to use ICD-10 codes as of Oct. 1, 2013.
Blindly accepting these myths as
truths may cost practices time, money, and the opportunity to use their ICD- 10 conversion and education to sustain and advance their practice viability. By debunking common myths and exposing physicians to the facts now, come Oct. 1, 2013, ICD-10 will be less intimidating. A proactive and strategic approach to the conversion will arm physicians with knowledge and better position them to achieve success with implementation.
Heather Bettridge is a practice management consultant with Texas Medical Association Practice Consulting.
February 2012 TEXAS MEDICINE 37
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