Monday, September 21, 2015

Ready or not, ICD-10 has arrived at last

- Kenny Lin, MD, MPH

After two separate one-year delays, the U.S. implementation of the International Classification of Diseases, Tenth Revision (ICD-10) code sets for medical diagnoses and inpatient procedures is now just 9 days away. If you are an employed family physician like me, you have probably been required by your employer to familiarize yourself with the new codes through face-to-face training or online modules. If you own your own practice, hopefully you have already confirmed with your electronic health record vendor that the switch to the new code sets will happen seamlessly on October 1st.

But if for some reason you have procrastinated, there is still time to get up to speed on the changes. To make this process as painless as possible, the editors of Family Practice Management have assembled a timely collection of links to articles on the ins and outs of ICD-10 coding, including their latest piece about documentation elements to support coding five common conditions in family medicine (asthma, otitis media, diabetes, well-child examinations, and hypertension). If you want to have all of this information in one place, you can purchase an e-book anthology available for iOS, Kindle Fire, Google Play, or Nook.

Although the increased diagnostic specificity that ICD-10 permits compared to ICD-9 can and should benefit the health system, FPM medical editor Ken Adler, MD, MMM warned in a recent editorial that doctors could lose in the short term:

We are told that we need ICD-10 for better quality reporting, public health research, health policy planning, fraud detection, and risk adjustment for quality based payments. That all sounds reasonable. But will the primary beneficiaries of ICD-10 turn out to be payers rather than patients? Will ICD-10 be used as just one more tool to delay or deny payment to physicians? ... There are plenty of reasons to be reasonably specific with our coding, ... but fear of not being paid should not be one of them. As physicians, we need to continue to make that point loud and clear.

Hear, hear.

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