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Physicians Should Get Ready to Implement ICD-10 in 2015


Robert Lorenz, MD, MBA, presents tips for physicians when they need to start using ICD-10 codes in 2015.

Concerns over the impact of implementing the ICD-10 coding classifications have led to much handwringing and four delays in its start date. Healthcare professionals need to spend the next year preparing to start using ICD-10 on Oct. 1, 2015, and not expect more delays or significant changes, according to two speakers at a Monday Miniseminar.

During “ICD-10: Implementation Delayed But Not Eliminated,” two speakers warned physicians and their staffs of the importance of being ready to hit the ground running on the new system in 2015. Robert Lorenz, MD, MBA, offered tips for physician coding and Annie Boynton focused on the general implementation of ICD-10. 

Dr. Lorenz is medical director of Payment Reform, Risk & Contracting for the Cleveland Clinic Health System. He walked attendees through differences between ICD-9 and ICD-10 codes, explaining the role of each character in ICD-10’s codes.

“The key to ICD-10 is the extension code,” Dr. Lorenz said. “You can’t keep using the same code over and over again.”

The six biggest changes physicians need to focus on are disease acuity, site, laterality, infectious agent, connecting the disease process with common manifestations, and the circumstances surrounding injury, which will not be a big concern in otolaryngology, he said.

The benefits of implementing ICD-10 are that it will collect more data that will improve quality measurement, public health, research, and organizational monitoring and performance, Dr. Lorenz said.

To avoid denials of claims in the new system, it will be important to consistently document specificity, he said. The process physicians should follow is to pick a code, then add documentation.

“This will change the process in the clinic, but it may make the process more efficient in the long run,” Dr. Lorenz said. He also said that the increased number of codes should not be a concern and that otolaryngologists should be able to focus on using about 200 codes that will be used most often.

Boynton echoed Dr. Lorenz, warning “not to panic” over the move to ICD-10, but adding, “Do not take this for granted. It can cause a detriment if you are not actively moving forward with some type of readiness plan.”

The principal at Boynton Healthcare Management Solutions, she has worked in health information management for 15 years in provider, payer, and educational capacities. Boynton said those hoping for yet another delay in ICD-10 implementation will probably be disappointed, adding, “Will implementation happen? Yes, I think it will happen.” The one-year delay of implementation has been estimated to have cost the healthcare industry $4 billion to $6 billion, she said, so industry supports change.

The next year gives all institutions and practices time to test their processes before implementation, Boynton said, adding that the next year provides an opportunity for documentation improvement and better vendor/payer communications.