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Industry        Surgeon

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Surgeon Roundtable: ICD-10 Code Implementation

Posted in Health Reform Watch | Oct 2012 | Comments (1)

Tags: electronic medical recordsmedical data collectionmedical billingcompliancebottom linecodingICD-10

ORTHOPRENEUR sought comments from the Editorial Board regarding impending changes to ICD billing codes, and the delay of implementation to 2014, asking:

  • Regardless of the extension, do you feel that you and your practice will be adequately prepared to implement the new ICD-10 codes?
  • What steps have you taken for the new code implementation? What challenges have arisen, and how are you facing them?
  • What do you expect to gain from the implementation of ICD-10 codes?

The surgeons' responses follow.

Q1: Regardless of the extension, do you feel that you and your practice will be adequately prepared to implement the new ICD-10 codes?

Jack Goldstein, M.D.:  I am not sure anyone will be really ready. This will undoubtedly put a tremendous burden either directly or financially on all physicians. Essentially requiring coding to mimic an EMR is adding another cumbersome layer onto a medical system that revolves around numbers instead of people. In the current scheme, about 20% to 30% of patients do not even fit into an ICD-9 or CPT code exactly. Although ICD-10 is trying to improve this…why?? What will we gain from adding descriptive codes to diagnosis and procedure? Will it improve patient care? Undoubtedly not. I am an advocate of Validated Outcomes Measures data collection. This has nothing to do with outcome at all, and actually adds nothing to patient care.

Charley Gordon, M.D.: Yes, we’re prepared.

David Kay, M.D.: No, the documentation burden is overwhelming. It's not clear how this will improve patient care.

 

Q2: What steps have you taken for the new code implementation? What challenges have arisen, and how are you facing them?

Jack Goldstein, M.D.: We have switched to a “Meaningful Use” EMR that has only been more burdensome because it is very code-centric. Clearly the people who wrote this were not physicians and did not realize you could simply attach a number to everything.

Charley Gordon, M.D.: Our software company is making changes and updating all tables to accommodate ICD-10. The challenges are trying to finish the EHR implementation, because it will be vital with all the new codes.

David Kay, M.D.: Our coders are preparing and we are looking at software systems.

 

Q3: What do you expect to gain from the implementation of ICD-10 codes?

Jack Goldstein, M.D.: Only more work, more wasted time and less payment.

Charley Gordon, M.D.: More detailed reporting and tracking of patient diagnosis.

David Kay, M.D.: Delays in patient care and upset patients and staff.

 

Q4: What have we not asked you about ICD-10 code implementation, that we should have asked? Please feel free to share additional thoughts.

Jack Goldstein, M.D.: Is there any valid reason to require everyone to use it? What is to be gained and at what cost?

David Kay, M.D.: How is this data going to be used to improve outcomes?

 

Drs. Lee Hieb and Blair Rhode diverged from the Q&A format, offering the following replies.

Lee D. Hieb, M.D.: At least when it comes to ICD-10, the government is honest in its intentions: improved data collection. But one has to wonder, as Tamzin Rosenwasser, M.D. points out in her wonderful article, “Call a Code: This Doctor’s Heart Stopped Beating,” (AAPSonline.org): “Who cares whether it was a macaw or a parrot that bit someone?” There are over 2,500 codes for non-union of bone. ICD-9 has three. Why does it matter that a subcapital hip fracture occurred on the second floor of a dwelling or the first floor? Will my patients get better treatment with the additional codes? Need I even ask if it will improve my efficiency of care?



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Charles Norrie 11/19/2012 11:56 AM
Do don't create barriers by pontificating