ICD-10: Do Patients Even Need To Know?

As long as things go smoothly from their perspective, most patients have little knowledge and less interest in medical billing, so it is probably not necessary to mention the ICD-10 transition to your patients. It might even be a bad idea.

"Explaining to patients ICD-10's requirements for additional documentation could cause them to wonder if documentation was lacking in the past," said Barbie Hays, coding and compliance strategist for the American Academy of Family Physicians.

Robert Tennant, senior policy adviser for the Medical Group Management Association, pointed out one scenario in which it might be advisable to inform patients, and another in which it might be unavoidable. If ICD-10 impacts patient flow - and it very well might, as productivity of providers and coders is expected to drop while they get accustomed to using the new coding system - explaining to patients the reason for delays might be necessary. In this case, Tennant recommends explaining to patients that additional government regulations are requiring extra paperwork. Most patients will have no trouble understanding or sympathizing.

Another scenario might be a little trickier. "Say a patient comes in with a sore elbow, but you neglect to designate left or right elbow when you code the visit. The claim comes back, and by that time you no longer remember which elbow it was." In this case, said Tennant, "you'd have to call the patient and ask." That might require a bit of explanation, and an awkward one at that.

In any case, when or what to tell patients is not a high priority for practices still struggling with ICD-10 preparation. Jennifer Perry, practice administrator for Alabama-based Norwood Clinic, a large multi-specialty practice, likely speaks for most if not all practices when she explained why the question of whether or not to tell patients about ICD-10 has not been on her radar.

"I have been so focused on training the physicians and staff in preparation for ICD-10 that I haven't given any thought to whether or not to discuss this with the patients. We seem to be overwhelmed with so many other tasks, such as trying to get patients using the portal to meet meaningful use measures, registering for group reporting for our Physician Quality Reporting System measures, and making sure our vendor is prepared for ICD-10 claims, that unfortunately in this instance, determining what, when, and how to tell the patients has taken a backseat."

She didn't rule out the possibility, though. "We are really engaging with patients with our portal, and I think their acceptance of the portal may drive us as providers to engage them more outside of the exam room," said Perry.