As a Client Manager with Network 1, I support many organizations with a majority of my clients being in the medical and financial arena. If you know anyone in the medical industry (my lovely and smart wife, Pam, is the Coding and Compliance Manager for a large orthopaedic practice in Metro Atlanta), you have probably been exposed to the predicted “DOOMSDAY” that will be October 1st, 2015, for on that day, ICD-10 becomes active law.
For those who have not had the 24/7 ICD-10 doom and gloom grumblings in their house (oh how do I wish), let me give you the 10,000 foot view of what ICD-10 is and why many practices are dreading this Thursday:
So, what does this seemingly simple coding change mean for every facet of the medical industry? Basically, if you want to get paid for the services you render, the providers (Doctors, PAs, etc.) must paint the complete picture of what’s happening to the patient with more detailed documentation in the office notes. That detail then allows the billing department to send the appropriate codes to the insurance companies, thus the practice gets paid for services rendered. Sounds simple, but just like predicted for Y2K, there could be many untested and unknown possibilities that might just bring the entire medical billing industry to a screaming halt. Medicare, Insurance, medical clearing houses… they could all become overwhelmed with heavy traffic, incomplete claims, and unforeseen oopsies.
According to Tom Sullivan, Editor-in-Chief, Healthcare IT News, “The ultimate irony of a long standing ICD-10 to Y2K comparison is that – after all the years of debate, disdain and doomsday predictions – it now appears that the go-live will likely pass after the same fashion that Y2K did: imperfectly but more or less quietly. None of this is to say that there won’t be problems in the near term but they are not going to be nearly as apocalyptic as so many have prophesized.”
The US medical industry has known the ICD-10 implementation was going to happen here for over 5 years and plans have been in the works for decades. Truth is, ICD-10 was endorsed by the Forty-third World Health Assembly in May 1990 and was implemented by all first-world WHO Member States by 2001, EXCEPT for the United States. The rest of world has figured out ICD-10 and so shall we.
My aforementioned super intelligent, beautiful wife Pam is also an AHIMA-approved ICD-10-CM Trainer Ambassador and has been leading custom classes and 2-day boot camps on ICD-10 for over a year. She has seen the look of dread and fear in the coders’ eyes when they enter her classroom. After a few hours of truth, they begin to relax and see ICD-10 for what it is, same ole same ole just with more special sauce. The most important takeaway she makes sure the students fully understand is that if they “READ THE NOTES!” then the 848 page AAPC ICD-10 Complete Code Book will guide them to the appropriate codes and all will be happy in the world.
As they depart her class with a newfound understanding of what is involved in the transition from ICD-9 to ICD-10, the coders seem to understand that ICD-10 is just a new and improved version of the old system. They also realize that the biggest challenge will most likely be helping the providers improve their documentation so they can code a visit correctly and thus get the practice paid promptly for the services provided.
So, will all the ICD-10 doomsday predictions go the way of Y2K, a non-event that was overhyped to the nth degree? The Experts seems to agree that ICD-10 will be a peaceful and relatively smooth transition for those who have prepared. We will know for sure on October 2nd.
Until then, Keep Calm and Code On!
With 25+ years working in the technology sector with a combination of educational and technical support consulting, Doug is committed to delivering the right solutions and services for clients and business partners. firstname.lastname@example.org or 404.997.7644
Network 1 Consulting is a 17-year-old, IT Support company in Atlanta, GA. We become – or augment – the IT department for law firms and medical practices. Our IT experts can fix computers – but what our clients really value are the industry-specific best practices we bring to their firms. This is especially important with technology, along with regulations and cyber threats, changing so rapidly. We take a proactive approach to helping our clients use technology to gain and keep their competitive advantage.
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