ICD-10 is kind of a big deal, which means there’s a lot of information about the new code set floating around out there. And—no surprise here—not all of that information is reliable. To help you separate fact from fiction, I put together the following list of the biggest ICD-10 misconceptions that are creeping through the grapevine:
1. Clinicians weren’t involved in the development of ICD-10.
Contrary to popular assumption, ICD-10 wasn’t created in some bureaucratic vacuum, totally void of clinical input. In fact, the new code set is the product of the same collaborative process used to develop and maintain its predecessor, ICD-9: a “public forum that continually welcomes input from individual physicians, physician specialty societies and other healthcare stakeholders,” notes this Greenway Health blog post. “From the beginning, all of the content of it really came from the clinical community,” said Sue Bowman, senior director for coding, policy, and compliance at the American Health Information Management Association (AHIMA), in the same post.
2. ICD-10’s sheer number of codes will make it nearly impossible to use.
While ICD-10 definitely contains more codes—about five times more, to be exact—than ICD-9, the added volume won’t necessarily make the code set more difficult to use. This FierceHealthIT article drives home that point with a dictionary analogy: “It won’t be more complex…just like adding words to a dictionary doesn’t make it harder to use.” Furthermore, the new code set includes an alphabetic index to guide users to the correct sections and subsets, and there are plenty of easy-to-use digital search tools—like this one—to help with code selection. Just be sure to steer clear of automatic crosswalking solutions that do not account for clinical analysis. (To learn why you shouldn’t trust crosswalks with your ICD-10 code selection, check out this blog post.)
3. ICD-10 already is out of date.
Sure, many countries already are gearing up for ICD-11, but ICD-10 isn’t going out of style anytime soon. In fact, since its introduction in the early ’90s, ICD-10 has undergone continual updates to ensure it’s always on-par with modern medicine. And while, as this post explains, CMS plans to pump the brakes on those updates during the year following ICD-10 implementation in the US, maintenance will resume as normal in October 2016.
4. The transition to ICD-10 will wreak havoc on clinic productivity and cash flow.
Yes, it’s going to take some time for the healthcare community to adjust to the new code set, but it’s not like providers will descend into a world of complete and utter chaos on October 1. In fact, as long as clinics make adequate preparations, their workflows should return to normal within a few weeks. As this ICD10 Monitor article explains, “AAPC studies show that productivity returns to normal following 40-80 hours of work with the new code set, not years.” Furthermore, if you’ve been diligent about getting your vendor ducks in a row—that is, ensuring that all of your clinic’s vendors and partners are ready for ICD-10—then your bottom line shouldn’t take too big of a hit. According to this article from Power Your Practice, it might take coders and payers a little bit of time to get into the swing of things after ICD-10 goes live, but “any decline in reimbursements will only be temporary.” Additionally, “Once your coders and payers gain their footing, ICD-10’s specificity may actually lead to higher reimbursements for your practice.”
5. Documentation must be absurdly specific for claims containing ICD-10 codes to be reimbursed.
Due to ICD-10’s plethora of crazy-specific codes, there’s a perception that patient documentation also must be crazy-specific. But the truth is, clear, complete documentation already is essential to providers’ compliance efforts—and that’s not going to change on October 1. So, if you’re already in the habit of creating detailed patient documentation, you shouldn’t have to change your tune too much once ICD-10 rolls around.
6. GEMs are an all-in-one solution to ICD-10 coding.
As explained in this post, GEMs—or general equivalence mappings—were “never intended to serve as single-code translation dictionaries.” Why? Well, due to their clustered structure, GEMs may map one ICD-9 code to several different ICD-10 codes, and vice-versa. And while they are useful for converting large batches of data—the kind associated with long-term clinical studies, for example—they’re not reliable enough for patient documentation.
7. There’s going to be another ICD-10 delay.
The anti-ICD-10 camp—which includes some pretty powerful physician advocate groups—has made strong pushes for another delay, but so far, those efforts have come up short. The federal government is standing firm on the October 1, 2015, transition date, and the closer we get to that go-live moment, the less likely it is that we’ll see another pushback. So, hold on to your hats—all signs point to the ICD-10 switch going forward as scheduled.
What rumors have you heard about ICD-10? Tell ’em to us in the comment section, and we’ll let you know whether or not they’re legit.