Lessons learned from the ICD-10 transition

November 23, 2015

We asked our ICD-10 Diary physicians to weigh in on the pros and cons of the new code set. Here's what they said.

Name:

Hungerpiller, MDJeanne Hungerpiller, MD
Family medicine
Savannah, Georgia

Biggest ICD-10 obstacle (to date):  Ensuring that the ICD-10 code chosen is the most accurate one to replace the old ICD-9 code (mainly this happens when coding for Type 2 DM), and keeping my temper from flaring due to the amount of time I waste doing this.

Easiest ICD-10 obstacle (to date): Using our EHR’s search function to convert ICD-9 to ICD-10.

I was smart to invest my money / my practice's money in TRAINING to assist with ICD-10. We used our software vendor as well as outside sources.

Read previous Diary entries here

True or false: My practice would have been ready for the Oct. 1, 2014 launch date: False

Most used ICD-10 code at my practice:  I10 (Hypertension)

Favorite ICD-10 code: Any of the ridiculous accident-related codes.  Why do the ER docs get all the fun?

Least favorite ICD-10 code: E11 (Type 2 diabetes mellitus and all its million variations)

Best piece of advice to peers struggling with ICD-10:  Just wait-I think it may get worse when the insurance companies start getting pickier about precision in coding (sorry, I don’t think that’s what they want to hear, but I think it will be the case. I think anyone who isn’t feeling like they are struggling now is in for a bit of a surprise in the not-too-distant future).

Are you ready for ICD-11?  Oh, dear god, no!

Next: I wish I hadn't invested in canned user training

 

Name:

Boland, MDMichael Boland, MD
Ophthalmologist
Baltimore, Maryland

Biggest ICD-10 obstacle (to date): Lengthy preparation

Easiest ICD-10 obstacle (to date): Selection of ICD-10 codes was made easy by the tools provided by our vendor .

I was smart to invest my money / my practice's money in the right EHR vendor to assist with ICD-10.

I wish I hadn't invested in canned user training that was not helpful to subspecialists .

True or false: My practice would have been ready for the Oct. 1, 2014 launch date: True

Most used ICD-10 code at my practice: Unsure

Favorite ICD-10 code: W56.21XA (bitten by orca; initial encounter)

Best piece of advice to peers struggling with ICD-10: There are better tools available for dealing with these codes. Ask your vendor whether they can provide them .

Are you ready for ICD-11? No, thank you ;-)

Next: Double checking the occasional bizarre ICD-10 match eClinicalworks finds  

 

Name: 

Siegel, MD, MSDaniel Mark Siegel MD, MS
Dermatologist
Brooklyn, New York

Biggest ICD-10 obstacle (to date): Double checking the occasional bizarre ICD-10 match eClinicalworks finds  

Easiest ICD-10 obstacle (to date): Falling back to familiar codes

I was smart to invest my money / my practice's money in ICD10charts.com which is free to assist with ICD-10.

I wish I hadn't invested in Treasury bills.

True or false: My practice would have been ready for the Oct. 1, 2014 launch date:  True

Most used ICD-10 code at my practice:  C44 (Other and unspecified malignant neoplasm of skin); a lot.

Favorite ICD-10 code: V97.33XD ( Sucked into jet engine, subsequent encounter); which is how ICD-10 makes you feel some days

Least favorite ICD-10 code: The correct one to use for dysplastic nevi as opposed to atypical nevi which is something you should look up if you want an interesting education in the big ICD-10 book.

Best piece of advice to peers struggling with ICD-10: Get over it. You learned ICD-9; you can learn 10 and with technology it is easier.

Are you ready for ICD-11? The rest of the world will be in two years. The U.S.? 25 years … maybe?

Next: It's still easier to find codes in ICD-9

 

Name:

Marsland, MDThomas A Marsland, MD
Oncologist
Orange Park, Florida

Biggest ICD-10 obstacle (to date): It's still easier to find codes in ICD-9.

I was smart to invest my money / my practice's money in staff training to assist with ICD-10. I really didn't invest any money other than anything related to our EHR.

True or false: My practice would have been ready for the Oct. 1, 2014 launch date:  Probably.

Favorite ICD-10 code: W56.21XA (bitten by orca; initial encounter)

Best piece of advice to peers struggling with ICD-10: Track denials.

Are you ready for ICD-11?  Yes.

Next: Are you ready for ICD-11? No . . . but why not have another hurdle to overcome?

 

Name:

Ellis, Jr., MDGeorge G. Ellis, Jr., MD
Internist
Youngstown, Ohio

Biggest ICD-10 obstacle (to date): Time searching for correct codes

I was smart to invest my money / my practice's money in educational courses to assist with ICD-10.

I wish I hadn't invested in: The amount of time.

True or false: My practice would have been ready for the Oct. 1, 2014 launch date:  True

Most used ICD-10 code at my practice: I10 (Hypertension)

Favorite ICD-10 code: I10 (Hypertension); it's the easiest to remember

Least favorite ICD-10 code: Diabetes because there are so many variations

Best piece of advice to peers struggling with ICD-10: Practice, focusing on the most important codes.

Are you ready for ICD-11? No, because I just finished preparation for ICD-10, but why not have another hurdle to overcome?

Next: I wish I hadn't invested in an outdated coding book

 

Name:

Seymour, MDElizabeth Seymour, MD
Family medicine
Denton, Texas

Biggest ICD-10 obstacle (to date):  The constant updating, changing of more extensive codes requires a lot more time, and makes our days longer.

Easiest ICD-10 obstacle (to date):  That our EHR system was prepared for the transition.

I was smart to invest my money / my practice's money in a great EHR vendor to assist with ICD-10.

I wish I hadn't invested in an outdated coding book.

True or false: My practice would have been ready for the Oct. 1, 2014 launch date: True

Most used ICD-10 code at my practice: E78.2 (mixed hyperlipidemia)

Favorite ICD-10 code: R94.39 (Other nonspecific abnormal function study of cardiovascular system)

Least favorite ICD-10 code: E07.89 (Other specified disorders of thyroid)

Best piece of advice to peers struggling with ICD-10: Purchase an EHR from a vendor that has history and experience with these transitions that are occurring in the medical field. They might be more expensive that other companies, but their price is worth it in the long run.

Are you ready for ICD-11? Absolutely not!

Next: Easiest ICD-10 obstacle (to date): Upgrade our software for ICD-10

 

Name:

Rafieetary, OD, FAAOMohammad Rafieetary, OD, FAAO
Optometrist
Germantown, Tennessee

Biggest ICD-10 obstacle (to date): Learning codes requiring laterality. (e.g. RT LT Bilateral)

Easiest ICD-10 obstacle (to date): Upgrade our software for ICD-10.

I was smart to invest my money / my practice's money in OptumEncoderPro 360 to assist with ICD-10.

True or false: My practice would have been ready for the Oct. 1, 2014 launch date: False

Most used ICD-10 code at my practice: H35.32 (Exudative age-related macular degeneration)

Favorite ICD-10 code: H35.32

Least favorite ICD-10 code: E11.359 (Diabetes codes)

Best piece of advice to peers struggling with ICD-10: Invest in ICD-9 mapping and any ICD-10 coding program. Try to gain as much knowledge you can on all the requirements for all the codes.

Are you ready for ICD-11? No. We are still learning all the ICD-10 requirements (hopefully we all are retired by then). 

Next: Are you ready for ICD-11? Good grief, no!

 

Name:

Miller, ODPamela J. Miller, OD
Optometrist
Highland, California

Biggest ICD-10 obstacle (to date): Determining the appropriate medical code and how many codes should be used for an encounter

Easiest ICD-10 obstacle (to date): Refractive code breakdowns

I was smart to invest my money / my practice's moneyin AOA Coding Package and NTEON EyeCor Billing and Coding with Report system to assist with ICD-10.

I wish I hadn't invested in quite so many lectures that were erroneous in the information given.

True or false: My practice would have been ready for the Oct. 1, 2014 launch date: False

Most used ICD-10 code at my practice: H52.4 (Presbyopia)

Least favorite ICD-10 code: Multiple codes for stroke - difficult to determine exactly based on patient report

Best piece of advice to peers struggling with ICD-10: Keep a master (or several masters) of the most frequently used codes in your practice and eliminate refractive codes with the word "unspecified."

Are you ready for ICD-11? Good grief, no!