Medical Survey Results: Doctors Share their Experiences with Billing Under ICD-10

The World Health Organization uses a standardized list of codes to describe medical conditions and procedures known as the International Classification of Diseases (ICD). Prior to last fall, the U.S. had not updated the ICD codes it had been using for more than 35 years.

 

Worried that ICD-9 contained too many outdated and obsolete terms, in the spring of 2014, the Centers for Medicare and Medicaid Services (CMS) announced that health care providers would be required to start using ICD-10 on Oct. 1, 2015.

 

Insurance companies were preparing for billing problems and payment delays as a result of the addition of tens of thousands of new codes, concerned that many providers would not be prepared for the CMS deadline.

 

And their concerns might have been justified. On the day of the transition, Forbes reported on a survey that showed more than 20 percent of physician practices had not received billing system updates necessary for ICD-10.

 

Still, just two weeks after ICD-10 went into effect, major insurers were reporting that the transition had been smoother than expected.

 

We recently asked several doctors around the country about their experience with the ICD-10 transition from a billing perspective and what, if anything, they wanted to say to Medicare.

 

Here's what they had to say:

 

 

"We haven't noticed any differences among insurers. Medicare: Why did you wait so long? ICD-10 was completed in 1992! That was 24 years ago."

 

 

"All major carriers were ready at the transition. I'd tell Medicare to do the management themselves instead of hiring regional carriers who are often clueless."

 

 

"Since we are grant and funding based, we don't have much interaction with insurance payers. We don't deal directly with Medicare."

 

 

"We have not noticed any major differences in our payors. Our biggest two are Medicare and BlueCross/BlueShield. I'd tell Medicare to please eliminate the practice of requiring certain meaningless 'magic words' and phrases in reports. It seems every year there is some new inane requirement. I remember several years ago if we didn't specifically mention flow in the IVC on an abdominal ultrasound report we couldn't bill for a complete abdomen. Then we went through the documentation of ER arrival time, scan time and report time for ER head CT's. Now we need to say that 'ultrasound was used to confirm vessel patency' if we use ultrasound guidance for line placement, even though that's not why we use it. As often as these requirements pop up, they will sometimes disappear the next year. I nave no doubt that there is a committee that randomly comes up with this nonsense as a way to deny and delay payments until we as radiologists catch on, then they move on to something else. Please stop it."

 

 

"Anthem Blue Cross/Blue Shield and Aetna have been the most prepared. To Medicare, I'd say be prepared for the post-August 2016 world, when submission of ICD-9 codes will no longer apply. I think there will be a backlog of charges that will accrue."

 

 

Centers for Medicare & Medicaid Services and many payers offer a grace period to providers to become acclimated to ICD-10 that ends Oct. 1, 2016. So despite the fact that it's been eight months since implementation, there is still the potential for some fallout once the honeymoon stage is over, the ICD-10 Monitor reported. 

This physician survey was conducted by PracticeSuite, helping over 25,000 medical professionals worldwide.

 

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