Tuesday, October 13, 2015

ICD-10 Could Be Getting Between You and Your Doctor

If you visited your physician this month, you might have noticed a longer wait time, or perhaps your doctor seemed a bit more preoccupied and spent longer clicking away at the computer. ICD-10 could be to blame.

ICD-10, also known as the International Classification of Diseases, 10th revision, is a system of codes doctors use to document all patient diagnoses. For decades physicians have used the 9th revision (ICD-9), but the government required an upgrade to ICD-10 on Oct. 1, and doctors say disruptions in patient care is a byproduct of this mandated transition.

The latest revision added tens of thousands of new ways to code for patient maladies. As Bloomberg put it, “There Are Now Officially 70,000 Ways to Get Sick and Die,” many of which seem a bit bizarre. Injured by flaming water skis? There’s an ICD-10 code for that. Problems in relationship with in-laws? There’s an ICD-10 code for that. Sucked into a jet engine? There’s a ― well, you get it.

Needless to say, the abundance of new codes take some getting used to — not just for physicians and their staff, but for any entity that deals with medical claims reporting, including the government, insurers, hospitals, and electronic medical record software companies. 

Accidental coding errors could cause insurance claim delays or denials. Patients could be sent erroneous bills by their insurance company. And any time physicians and their staff spend figuring out the proper code or dealing with breaks in claims processing is time spent away from patient care. 

A TMA survey taken just before the launch of ICD-10 revealed nearly two-thirds (65 percent) of physicians had little or no confidence that their practice was prepared for the transition. More than 80 percent anticipated delayed or denied Medicare claims. More than one-third (36 percent) predicted the disruption would force them to draw from personal funds to keep their practice afloat so they could keep taking care of patients.

“I hope patients will not notice any delays or changes in quality of care, but every doctor I’ve talked to is very, very worried,” said TMA President Tom Garcia, MD, in a news release prior to Oct. 1. “I think that doctors will continue caring for patients, but the implications are that the patient-doctor relationship is going to be stressed.”

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