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ICD-10: Painful To Implement, Painful To Delay
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cdavant3
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cdavant3,
User Rank: Apprentice
3/31/2014 | 2:12:35 PM
ICD10 delay
Sorry folks, but I'm one of hundreds of over 65 Family Docs in private practice who are planning to close our practices 9/30/14 if ICD10 isn't delayed. It's going to cost tens of thousands to convert and there will be zero return on that investment. Most of us are living hand to mouth paying our help now and the advice to "have six months revenue in reserve" or "open a line of credit" isn't realistic. It makes perfect sense to use ICD10 at the hospital level and a much more limited set at the office. If you think there is any clinical benefit in letting an insurance carrier know if a kid has a left or right ear infection or if you hit your head walking into a lamppost you have major problems.
LewisL957
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LewisL957,
User Rank: Apprentice
3/31/2014 | 3:33:54 PM
What's in it for Me?
ICD-10 is "granular."  It lets researchers, insurance companies, the feds, and anyone else who gets their eyes on the data do great things.  This data is valuable.  To get this data, I, a solo practitioner, must buy software, recode the diagnosis for every patient, code it again the next visit as the specificity has changed, and so on. 

 

And what am I paid for providing this valuable data?  Why, nothing at all!  In fact, if the computer at the other end doesn't like my code, I don't get paid for my work.  And the payments here in primary care land are, shall we say, inadequate for the work we do, let alone for the data processing services we are required to provide for free in order to get our pay.

 

I say it's spinach, and I say the heck with it.
David F. Carr
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David F. Carr,
User Rank: Author
3/31/2014 | 4:06:54 PM
Re: ICD10 delay
Maybe the approach the Cleveland Clinic CIO suggests really is the best - let the big organizations move forward with ICD-10 even if others aren't ready - and government and insurers should figure out a way to let that happen.

On the other hand, it sounds like some docs will never be ready. Don't you trust Athenahealth or some other EHR / practice management vendor to smooth out the rough edges for you?
anon2858894915
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anon2858894915,
User Rank: Apprentice
3/31/2014 | 4:22:54 PM
Re: What's in it for Me?
Doctors have a hard enough time following the rules of I-9; yeah so I 1-10 will be a nightmare.

 
rjohnston2268
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rjohnston2268,
User Rank: Apprentice
3/31/2014 | 4:56:20 PM
Convert and Train You Entire Staff in 90 Mins for $1,788 Annually (Mapping and Dual Coding) in Seconds
The numbers being thrown around by, "The American Medical Association predicting this will be extremely costly for physicians, is false!!!!!  "The AMA estimates the cost of switching to ICD-10 at as much as $8 million for a large physician practice and more than $225,000 for a smaller one".  This is also grossly inflated.

 

What if I told you we have a solution that is cloud based and can covert the ICD-9 code to ICD-10 code in less than 2 seconds as well intelligently build your common codes automatically, in real-time with in a few seconds.  And your staff can be trained with in 90 mins at a cost of $1,788 per provider annually or $149.00 per month.  I demoed this to 3 well known health systems in Northeast, Ohio and the first comment I received was when can I get it and how much. 

 

The government and the Big 5 Consulting firms are trying to scare all of these small practices and the large health systems in to thinking it will cost millions.  That is a completely false.  It will cost a small community health system in Ohio with 127 doctors in the network roughly $227,076.00 Annually ($1,788.00 avg., per provider), for all 127 practices.  These are estimates, but based on what we where going to quote a small health system this is pretty accurate.   I challenge anyone on this. 

Contact me at:  rjohnston@strongbasehc.com 

 

Key Features Of our Solution: 

•       Explore ICD-10 Chapters 

•       Search ICD-9 GEM's. 

•       One click access from GEMs to ICD-10 code details 

•       Forward and backward GEMs with 2 clicks 

•       Auto complete Index search 

•       One click navigation from Index to Table 

•       Search directly in ICD-10 Table 

•       One click navigation to Exclude codes 

•       Color-coding based on CMS guidelines. 

Key Benefits Of our Solution: 

•       Convert your existing ICD-9 cheat sheets to ICD-10 SmartSheet in seconds. 

•       Utilize GEMs to create Personalized Crosswalks with just a few clicks. 

•       Dual Coding 

•       Review relevant notes and guidelines at time of selecting the code. 

•       Color-coding to ensure selection of only valid codes 
sburgernutr
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sburgernutr,
User Rank: Apprentice
3/31/2014 | 5:09:50 PM
Re: What's in it for Me?
Lewis, as a solo practitioner in a small field that is not well recognized by insurance companies I actually find the ICD-10s to make sense for my profession.  They diagnoses are clear cut, unlike the ICD-9s which require all sorts of extra digits that make no sense whatsoever.  I can't tell you how many practitioners in my profession have rejections thanks to the need to add the "fifth digit" codes for the ICD-9s. 
sburgernutr
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sburgernutr,
User Rank: Apprentice
3/31/2014 | 5:15:24 PM
Re: ICD10 delay
cdavant3, I am a board member on a professional association for about 100 SOLO practitioners.  I just sat down myself and went through the ICD-9 and the ICD-10 codes for conversions.  For our profession the new codes are spectacular and very straightforward.  The old ICD-9 codes really are inadequate and give the insurance companies more leeway to deny our claims.  I for one regret the delay.  I found one of those coding websites that only cost about $50 a month.  It wasn't that hard to work with. I created superbills and a coding book for all our members.  It was not rocket science.
LSPEECE
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LSPEECE,
User Rank: Apprentice
3/31/2014 | 6:52:26 PM
True, but....
Good points on both sides. As a facility medical coder, we have no idea what the small physician offices have to go through to make ends meet. I see your pain. On the other hand, why did the rest of the civilized world move to ICD10 in the 1990's? They somehow managed to make the transition well enough and Australia, for one, is in the 8th edition of ICD10 now. The US refuses to bite the bullet in all things fiscal and do what needs to be done and utilize all the modern technology we have available to us in the 21th century. I think that reimbursement would increase with the detail available in the new codes. I like the compromise the family doctor suggested a few posts ago and letting the large facilities move to ICD10 in 2014 and postponing it for the small offices to 2015.
David F. Carr
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David F. Carr,
User Rank: Author
3/31/2014 | 6:53:23 PM
Re: Convert and Train You Entire Staff in 90 Mins for $1,788 Annually (Mapping and Dual Coding) in Seconds
I hear a lot of this from EHR vendors, that ICD-10 shouldn't be a problem if only everyone would convert to their wonderful product. May even be some truth in it. Just got the cook's tour of Modernizing Medicine's iPad-based touch interface for recording patient encounters, which comes in custom editions for specialties like dermatology. Easy to see how working with a 3D model of the patient makes it possible to specify the correct region of the body without looking up a code. But you have to be in one of the specialties they cover for it to be helpful.

The emergency room doc I spoke with is worried about having to use multiple EHRs at different hospitals he contracts with. On October 1, doctors are going to be using all sorts of EHRs at different levels of capability related to ease of use and ICD-10. They're not all going to flock to your product or any other. Whenever this transition happens, it's going to bring pain and disruption -- the question is whether the time has come to get it over with.
David F. Carr
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David F. Carr,
User Rank: Author
3/31/2014 | 6:56:42 PM
Re: True, but....
Remember that the US edition of ICD-10 is not the same as what's used elsewhere in the world. There is a base international standard, but multiple variants and additional codes layered on top of it -- with the version specified in the U.S. probably more complex because it's being used for billing rather than just statistical tracking.

This is where my liberal friends would point out how much simpler things would be in a single payer system.
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