Medical Survey Results: Doctors Weigh in on The Transition to ICD-10

After years of delays, in the spring of 2014 the Centers for Medicare and Medicaid Services announced that beginning Oct. 1, 2015, health care providers would be required to use the latest version of the International Classification of Disease (ICD), a standardized set of codes for medical conditions and disease.

 

ICD-10 would be the first update for the medical codes the U.S. uses for diagnosis and billing in more than 35 years.

 

As the deadline for the implementation of ICD-10 neared last October, many healthcare providers had concerns about how easy the transition would be. There were predictions of delays system failures, an increase in the number of denials and lost revenue.

 

Fortunately, thanks to thorough planning and training, the overall consensus (so far) seems positive.

 

We recently surveyed several doctors, asking any stories they had relating to the transition and what they thought of the new coding procedures. Here's what they had to say:

 

 

"I can't think of any stories to speak of. One disadvantage has been coming up with symptoms that meet criteria for billing."

 

 

"I'm happy to report that there have been no issues. There are no real advantages that I can see. One disadvantage was all the work required to switch over."

 

 

"We are an international company so we are finding some of the new countries want to move to ICD-10 and certainly know they need to, but they fear it may not be regionalized enough. I think the greatest advantage is the ability to narrow down a disease into a more specific subtype. I think a huge disadvantage is the cost to train staff on the use of the system."

 

 

"I don't have any stories that are specific to our transition. It was smooth. The most amazing stories relate to the number of codes, and no matter how bizarre the history, there seems to be a code for it. I heard a story about someone being injured when his or her water skis caught on fire, and yes, there is a code for that. A definite advantage is better patient histories. The biggest disadvantage is the need to instruct the ordering physicians on the increased level of detail required, thus necessitating increased expense in tracking down needed information."

 

 

"I have run into some issues with inappropriate mapping of ICD-9 and ICD-10 codes, e.g. a lack of specificity to justify a medication. However, these issues are easily remedied and I have not experienced difficulties getting treatment to patients. An advantage has been the increased specificity of diagnoses, which is helpful in terms of describing a particular concern. There are some superfluous and/or eccentric diagnosis included in ICD-10 - diagnoses that would never arise which I think is a disadvantage."

 

 

Some experts warn that transition isn't over yet. A recent article on the ICD10Monitor.com reminds that providers are in the "honeymoon stage" of acclimating to the new codes, and that by Oct. 1, 2016, the end of the Centers for Medicare and Medicaid Services grace period, they might be singing a different song. 

 

We constantly hear how AI is creeping into every aspect of healthcare but what does that mean for medical coders and how can we better understand the language used in the codeset? Will AI take my place or will I learn with it and become an integral part of the process that uses AI to enhance my abilities? 

Medical coding contractors offer a valuable service to healthcare providers who would rather outsource coding and billing rather than handling things in-house. Some contractors are better than others, but there is one thing they all have in common: the need to present some sort of value proposition in order to land new clients. As a contractor, your value proposition is the advantage you offer. And that advantage is specialization.

Chronic respiratory disease is on the top 10 chronic disease list published by the National Institutes of Health (NIH). Although it is a chronic condition, it may be stable for some time and then suddenly become exacerbated and even impacted by another acute respiratory illness, such as bronchitis, RSV, or COVID-19. Understanding the nuances associated with the condition and how to properly assign ICD-10-CM codes is beneficial.

According to the FDA, CDC, and other alphabet soup entities, the old COVID-19 vaccines are no longer able to treat the variants experienced today so new vaccines have been given the emergency use authorization to take the place of the old vaccines. No sooner was the updated 2024 CPT codebook published when 50 of the codes in it were deleted, some of which were being newly added for 2024.

With approximately 250,000 cases of acute appendicitis diagnosed annually in the United States, coding updates were made to ensure high-specificity coding could be achieved when reporting these diagnoses. While appendicitis almost equally affects both men and women, the type of appendicitis varies, as dose the risk of infection, sepsis, and perforation.

COVID vaccine changes due to the end of the PHE as of November 1, 2023 are addressed in this article.

2023 brought quite a few changes to Evaluation and management (E/M) services. The significant revisions as noted in the CPT codebook were welcome changes to bring other E/M services more in line with the changes that took place with Office or Other Outpatient Services a few years ago. As part of CMS’ Medicare Learning Network, the “Evaluation and Management Services Guide” publication was finally updated as of August 2023 to include the changes that took place in 2023. If you take a look at the new publication (see references below),....