ICD-10: Getting Ready When You'd Rather Ignore It

Betsy Nicoletti, MS


January 08, 2014

In This Article

ICD-10 Is Coming This Year

Many physician practices have avoided getting ready for ICD-10 (International Classification of Diseases, 10th edition) for a variety of reasons:

Some hope that the Centers for Medicare & Medicaid Services (CMS) will postpone implementation yet again and don't want to waste time and money preparing for something that won't happen.

Small groups have limited staff and budget for training and think that learning ICD-10 closer to the due date will be more effective than learning it too early.

One physician worried that if she paid to send someone on her staff to learn ICD-10, the staff member could demand a higher salary or find a new job.

Some groups feel they've invested enough time and energy into reporting on quality measures in CMS's Physician Quality Reporting System, installing an electronic health record (EHR), and meeting the requirements for meaningful use.

Physicians and managers with an optimistic outlook hope that their practice management system or EHR will provide an easy, seamless translation between ICD-9 and ICD-10 diagnosis codes.

But the clock is ticking. Implementation of the new code set is less than a year away. CMS has repeatedly stated that despite reports that small practices and systems may not be ready, there will not be another delay in the implementation date. Failure to prepare for ICD-10 could mean a delay in claims processing or denials. And delays and denials translate into empty bank accounts.

Resistance is futile! Now that the calendar reads 2014, it's time for practices of all sizes to prepare for ICD-10. What practical, concrete steps should a medical practice take?

One important point: There are 2 ICD-10 code sets. The first, ICD-10-CM (International Classification of Diseases, Clinical Modification), is diagnosis coding. All healthcare providers will use ICD-10 for diagnosis coding. The second is ICD-10-PCS (International Classification of Diseases, Procedure Coding System), which is used only by facilities to report inpatient procedures. Physician practices will continue to use CPT (Current Procedural Terminology) to report what service was performed.


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