Thursday, August 20, 2015

Medical Coding and Billing Overhaul Could Disrupt Patient Care, Physicians Say

TMA survey shows too few doctors prepared for ICD-10 transition; some may retire, borrow to keep practice afloat


If physicians’ predictions are accurate, patients might need to brace for disruptions in doctor visits this fall. 

Most Texas physicians say they are not confident their practices are prepared to use the new medical coding and billing system by Oct. 1, according to a new report. That is the deadline the federal government imposed for all physicians to start using the 10th revision of the International Statistical Classification of Diseases and Related Health Problems, or ICD-10, to document all patient diagnoses and treatment. The doctors’ concerns were revealed in a new Texas Medical Association (TMA) survey regarding practice readiness for the new system. Some physicians might even retire early as a result of the anticipated disruption stemming from the overhaul.

Nearly two-thirds (65 percent) of all physicians responding have little or no confidence that their practice is prepared to transition to ICD-10 by the deadline, even though the new coding system is supposed to enable doctors’ offices to collect and report more detailed patient data.

“It’s horrible,” said TMA President Tom Garcia, MD. “The United States is the only country that couples the ICD coding with payment. The implications are that the doctor-patient relationship is going to be stressed.”

Only 10 percent of physicians are “very confident” their practice is prepared to transition. More than half of the solo physicians are “not at all confident” their practice is ready for the big switch. That could spell disruptions in patient care considering solo doctors comprise close to half of the physicians in the survey (42 percent).

Physicians fear the massive switch to the new coding system will disrupt patient care, and delay payment. In fact, 83 percent of the doctors anticipate delayed or denied claims because of the transition, regardless of specialty. More than one-third of the physicians expect disruption so bad they will have to draw from personal funds to keep their practice open (36 percent), and almost one-third (30 percent) might retire early over anticipated cash-flow problems.

The federal government mandated the upgrade from the current coding system, ICD-9, which has 13,500 diagnosis and procedure codes, to ICD-10, which has 69,000 codes. 


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