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11/18/2013 Joshua Kaye, DPM
ICD-10, a Recipe for Disaster? (Neil H Hecht, DPM)
In reading through various articles and blogs regarding the October 1, 2014 looming date for the conversion to ICD-10, it is beginning to sound like the fears during 1999 considering Y2K. Unless I am very naïve or missing the point, the complexity of the transition appears to be exaggerated. There are two distinct components to the transition. One part is the upgrading to the new ICD-10 code number which contains two or more digits than ICD-9. The second part is strictly a software change, involving both the EMR and the billing software. So let’s take a look at these two components. ICD-10 requires a greater level of specificity for a diagnosis and the increase of the number of digits of the diagnostic code will demonstrate that specificity. So if we have a patient with an ankle sprain, for example, ICD-10 will require determining whether the injury occurred while playing soccer or as a result of a car accident. That doesn’t seem so difficult. If the upgraded EMR, interface program and billing software is appropriately written, if the ICD-9 code is entered, that should trigger a selection of appropriate ICD-10 choices. Once the appropriate ICD-10 choice has been determined, the increased software field size should then allow the upgraded code to be digitally transferred to the billing software and on to the insurance company or Medicare. Assuming that the software is written in a user-friendly manner, we would not be concerned with that portion of the new process.
There may be tens of thousands of new codes with ICD-10, but realistically, as with any medical specialty, we would likely only use a tiny fraction of those new codes. Using the above example of the ankle sprain, of all the different ICD-10 codes, I don’t believe one code will result in a greater payment than another for the same injury. The level of patient care will not improve or change. And if an error in the selection of the precise ICD-10 code is made, I don’t believe that will result in an audit. ICD-10 was designed for the bean counters of the medical world. Honest errors in ICD-10 code selection will be rampant during the early stages of the conversion. Putting future changes of healthcare into appropriate perspective, ICD-10 conversion will be one of our smallest concerns. Joshua Kaye, DPM, Los Angeles, CA, jk@joshuakaye.com
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