Oct. 1, 2015 — the implementation date for ICD-10 — came and went with none of the drama that had been foretold. Many experts compared it to Y2K, an event we'd been warned might bring all of civilization to its knees. As with Y2K, predictions of a crisis were greatly overblown. The flood of denied claims and lost revenue that could put smaller practices out of business didn't happen.
"It went surprisingly well," says Barbie Hays, coding and compliance strategist for the American Academy Family Physicians. "We had a few phone calls; there were some questions about whether preventive services are [billable] with a problem visit and everybody was trying to figure out what to do with the hilarious accident codes, like 'struck by orca, initial encounter,'" Hays says, laughing. "But generally it was not nearly as bad as people expected."
Prep Paid Off
While the smooth transition was unexpected by many, it probably shouldn't have been that much of a surprise. To most experts, this was definitely a situation in which preparation paid off, and most practices were at least reasonably well prepared. The repeated postponements of the implementation date had caused some experts to fear a "boy who cried wolf" effect, giving practices the impression that ICD-10 was never actually coming and causing them to give up preparing for it. In the end though, most practices made good use of the extra time. "It was almost a non-event for us," says Carl Olden, a family physician in Yakima, Wash. "We were ready even before the last delay." The only challenge for Olden's group was keeping everyone interested and up to speed during the delay, but they managed it. "We pushed the message that better documentation equals better care," he says. Olden's six physician practice focused on the advantages that ICD-10 offers in terms of telling the full patient story — identifying comorbidities and stratifying risk. The strategy was successful. "We wanted our physicians to be educated," he says.
Olden's practice made use of resources available from CMS. "They actually worked," he says. Yet, even with such attention to preparation, the group was still concerned about productivity losses. "We thought it would kill us — taking the extra time to document everything so carefully," Olden says. "But we've had no productivity loss and no billing loss. With the [EHR] platform we're using, we get a screen with all the subchoices," he says, "Once you've learn it, it's just a few more clicks and not much more burden at all." The education is ongoing. "We're teaching people to not be too dependent on crosswalk codes," Olden says.