One Doc 'Pleasantly Surprised' by ICD-10 Transition

The era of good feelings about ICD-10 seems to be in full throttle at physician practices across America.

So far so good, or so it seems.

In the months and years leading up to the Oct. 1, 2015 transition date, harbingers of doom seemed to equate ICD-10 to the big bang. Instead, for many offices, especially those who prepped for the switch, it has been more like a small whimper - a hardly noticeable change. According to a new survey at KPMG, a New York-based advisory firm, 80 percent of healthcare organizations have said their transition to the coding set was successful.

One such doctor that's found the switch to be no sweat is Theo Felts, a family practitioner in Overland, Kan. Felts runs a solo-doc, walk-in urgent-care center for acute illnesses and injuries. Because of this, he said the transition was a bit easier for his practice. Still, he prepped for the transition and benefited from his EHR.

Felts recently discussed his successful ICD-10 transition with Gabriel Perna, Physicians Practice managing editor. Below are excerpts from that interview:

Physicians Practice: What was your strategy on ICD-10?

Theo Felts: The biggest thing I had going leading up to [ICD-10] is because I am outpatient only, it's pretty limited on the coding I use. It's all outpatient codes, and most of the same codes over and over again. … it's all the basic stuff. Going ahead, I was prepared with a walkover menu. I knew all the codes I used in ICD-9 in my head. I knew the crossovers in ICD-10, and all I had to do was look it up on a cheat sheet and entered them in. That was before I looked into what capabilities my EHR had. Now that I've been doing it for a month, I don't need the crossover sheet, my EHR does it for me.

PP: When did you switch on Oct. 1? Or did you complete prep work before?

TF: I had my crosswalk sheets ready to go [before Oct. 1]. The week before, I looked into what the conversion function was in the EHR. I dabbled around with that and found out that it was set up nicely. It prompted me what ICD-10 codes were going to be needed as of Oct. 1 and after Oct. 1 [would be] mandatory. It really pointed me in the right direction.

PP: How did that work in the EHR?

TF: It has worked quite nicely. I can still enter ICD-9 codes and it will convert them for me. I can search both 9 and 10 codes. I have both of those on my superbill. If I know my 10 codes, I can type those in as well.

PP: What have been some challenges you've faced in this transition?

TF: The biggest thing I was worried about, hearing the talk in the industry about the loss of revenue and delays in payment within the transition from 9 to 10. As a small practice, I have to worry about keeping the business afloat and making payroll. The specifics of the codes I wasn't too worried about. So far it's gone smoothly though, there hasn't been a big drop off in practice receipts on the conversion to 10.

PP: Do you feel you have an advantage as a smaller practice in this transition?

TF: I feel it's an advantage. I don't have any inpatient codes I'm dealing with. We don't do a lot of different procedures. The procedure codes haven't changed. Trying to find the diagnosis code to go with the procedure code isn't a problem because we're not doing a lot of in-depth procedure type functions. That part, because we're fairly streamlined, has been helpful. The other thing about being a smaller practice, you are able to keep a closer watch on things. I have an outside billing company I work with. They can keep a close watch on things. I can know what trends are fairly quickly before I get in trouble with a lot of claim denials.

PP: What's your advice to others who are struggling with the transition?

TF: For me specifically, the function in my EHR was a night and day difference as far as putting my mind at ease. If you are having problems, look at what you are doing with your EHR. Why isn't it more of a tool to help with the transition?

PP: What are you expecting going forward with denials?

TF: At this point it seems like we are doing okay. I don't see a big increase in denials. Going forward, this should be the worst of it. As we go forward, I expect it to get better. I don't think there will be a big issue for the flow of business and flow of receipts to the business. We can keep plugging along.

PP: Anything else?

TF: I have been pleasantly surprised. The only issue I've found is it does take a while to wade through the codes. Things like fractures and injuries, there are more options to choose from, so it takes me a little bit longer, and being in urgent care, you want things done quickly and efficiently. Hopefully I'll get some of those seven and eight-digit codes remembered. That might take a while though.