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One Practice's ICD-10 Experiences at Six Months


It has been six months since what was supposed to be a disastrous change to ICD 10 occurred. I'm happy to say we are still in business and surviving.  Although no one looked forward to the change and dreaded what could have happened, it appears the delays allowed the insurance companies and EHR vendors to be well prepared and prevent delays. 

I didn’t do much preparation or learning of the new codes. My EHR vendor did a good job with an easy crosswalk program, allowing the entering of ICD-9 codes that displays choices in ICD-10.  It also featured a search function by diagnosis, which has overall worked well. It's sometimes not as easy as ICD-9 but we are learning as time goes along.  We still laugh when unusual choices pop up and can’t wait to pick the code for things like struck by turtle or pecked by chicken, initial encounter!

As of now we have had no coding issues with insurance companies questioning or denying claims due to coding.  Luckily in family practice there is a short list of common codes most often used, which we are have already begun to memorize. I know some specialties, like orthopedics and emergency medicine, have a larger set to choose from and need more specificity for coverage.  The next year will tell if insurance companies get more strict in code review and deny for lack so specificity. 

I had great concern over the last few years and discussed with many colleagues who were doing significant preparation with courses or flash cards. Luckily, my choice to rely on my EHR and other crosswalk programs has paid off.  They have worked fairly easily and only about once or twice a week do I struggle with unusual or vague diagnosis that are difficult to code. 

Overall ICD 10 has worked well, I'm still not sure it helps in the care of our patients or makes us better doctors, but at least it was a fairly smooth transition for us.

Deborah Winiger, MD, practices family medicine at North Suburban Family Healthcare in Vernon Hill, Ill., and is a member of the Physicians Practice Physician Advisory Board.

This article was originally published in the April 2016 issue of Physicians Practice.

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