With ICD-10 if we use lots of non-specific codes it will be a red flag for an audit.
John, like Tom, I would be interested in seeing sources for this, but until I see something convincing, I will take this with a grain of salt.
The insurance companies and government try to keep us in line using fear of audits. There are many docs who didn't participate in MU at all because they said "the government will just use audits to take it all back". Sure, there were (and still are) audits, and they can be a pain in the neck, but the great majority of people who attested and got MU funds were not audited and few gave the money back.
This is not the place for a full discussion of ICD-10, and I am certainly not an expert, but looking at the codes, I think some of this fear is overblown.
The possibility of audits has always been there, even in ICD-9. Have you heard of anyone who had an audit for this?
As a GI, of course abdominal pain is a big deal for us. 789.00 is "unspecified" and .01-.09 denotes RLQ, epigastric, etc. We try to be specific, but sometimes we code the 789.00. I have never been asked for a more specific diagnosis, let alone something like an audit.
And guess what... the code in ICD-10 for unspecified abdominal pain is R10.9. Then there are 9 more codes for the various areas, just like in ICD-9. Are there other codes to make it LOOK difficult? Sure, but let them try to audit me because I coded for "abdominal pain" rather than "abdominal tenderness".
I am sure there will be aspects of this that will be a hassle, but I think our goal should be to make the required adjustments without living in fear or fundamentally changing the way we do business.
