Early Lessons of ICD-10 for One Practice

ICD-10 has arrived without much fanfare at our organization.  This is probably because we’ve dual coding (ICD-9 and ICD-10) for over a year and because it is the lull before claim denials start coming in.  There are many lessons to learn from the ICD-10 transition -many, I suspect, will come out over the new few months. However, as we stand on the threshold of this momentous change, I can’t help but reflect on some of the early lessons:

1. This is a nail in the coffin for small, independent practices. The amount of complexity and support by both personnel and technology to get our organization transitioned to ICD-10 causes me to wonder how it can possibly be done by a one or two-doc shop. How many more solo practitioners will either transition to direct primary care or simply retire as the federal regulations require compliance with increasingly difficult-to-implement systems?

2. There is a level of absurdity that has crept into my day-to-day business that defies common sense. We all joke around about the silly codes involving water animals and accidental falls into manholes.  However, all joking aside, it’s a waste of everyone’s time. While increased specificity of diagnosis codes has some reasonable benefits, too many of these codes add nothing but frustration and a good cartoon or two.

3. We are all in this together. Physicians need to unite behind the tenets that have guided medicine well over the last century.  We must push back against the forces that are compromising the care we provide. Enough with distractions and interruptions that do not further the care of our patients.

4. Nothing is as bad as it seems. ICD-10 has loomed large over the last few years. It is not to be feared. Like many administrative tasks, it has to be managed. We need to get creative on how to incorporate a new set of rules into our clinical practices, but we also need to keep things in perspective.

5. Medicine remains awesome.  I get impatient with so many things in a typical clinical day. However, I have to admit that taking care of patients, building relationships, being the “hero” at the end of the day remains a privileged position. So, while I may become disillusioned with many of the nuts and bolts of payment for my services, the service I provide is still a joy.

So, my fellow ICD-10 veterans, I hope that the next few weeks bring you many approved claims, a good laugh at some of the more ridiculous codes, a set of short-cuts to work-around the inconvenience of ICD-10, and hope that as we become increasingly burdened with regulations, we will find a way to clear the cutter and refocus on what matters most - what happens between us and our patients.