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#53253 04/11/2013 2:32 PM
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I saw an old forum on ICD-10 in 2011. Kind of dropped I guess because it was put off.
Can we assume AC will be up to speed for ICD-10?



P Sundwall
psundwall #53257 04/11/2013 3:19 PM
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You have heard the definition of ASSUME = making an [censored] out of U and ME.
Let's hope so.
Let's hope that AC can make it really easy for us.
As the CMIO of our local community hospital I've sat in on ICD-10 planning. We are looking at a 50% increase in coders to accommodate ICD-10, an expected 25% rise in AR days, and substantial "hit" on revenue due to "not being right" in coding.
ICD-10 is the HIPAA of the 2010's and is ON TOP of MU1 and MU2.
</rant off> sick


Roger
(Nephrology)
Do the right thing. The rest doesn?t matter. Cold or warm. Tired or well-rested. Despised or honored. ? --Marcus Aurelius --
psundwall #53279 04/12/2013 10:55 AM
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I'm sure AC can do ICD-10

I'm you can program the Staten Island phone book list (ICD-9), you can do all of NY City (ICD-10)

Roger's point is the right one. "Let's hope that AC can make it really easy for us."

I use 714.0 for RA, and it will be replaced with 3 pages of codes in ICD-10

I won't be able to know the right code unless it hasn't changed from the patients previous visit.

I doubt the insurance companies will have programmed their computers for every code enough to start rejecting claims in 18 months. I imagine they will start out with some common diseases and clamp down slowly on the rest, but they could surprise me as not paying claims is their game in life.

Worst case scenario is needing a third party program to find the right code and then enter it into AC.



Dan
Rheumatology
psundwall #53283 04/12/2013 12:59 PM
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Our PM company suggested we start saving because the insurance companies will be slow to reimburse. They are predicting 78,000$ in costs to get smaller offices up and running on ICD 10 as well as cover delay in reimbursement!!!!?.

I am going to [censored] U ME that if AC is up to speed and their PM is up and running by then with fully funcional ICD 10 coding it will be a slam dunk...HA!


P Sundwall
psundwall #53290 04/13/2013 12:06 AM
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My most common ICD-9's map 1:1 to ICD-10 (CKD flavors)
reasons for the CKD: multiple permutations of GN dx: that will drive me nuts. I thank God I'm not surgeon or an ortho!


Roger
(Nephrology)
Do the right thing. The rest doesn?t matter. Cold or warm. Tired or well-rested. Despised or honored. ? --Marcus Aurelius --
psundwall #53365 04/16/2013 6:27 PM
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IT's going to be a nightmare for us in primary care. They should allow primary care to use a general parent code and make you specialists explain details. smile Apparently it's not going to be just a skin lac, but a lac of the lower portion of the tibial zone of the lower leg, anterior/inferior, open not closed, and received in water on a hot day by an Crocodile of the angry disposition!


Chris
Living the Dream in Alaska
psundwall #53376 04/16/2013 8:15 PM
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Getting the right code for today's visit is hard enough.

But the insurance company will have codes from all the visits of all providers. If you pick a code at odds with the patient's previous history, you could trigger an audit/request of records/payment delay.

Putting clinical details into the diagnosis code is probably a good idea from the insurance industry's viewpoint, cause it makes it much easier to program their clinical guidelines into their payment blockade, but it will add significantly more time to every visit if you choose the diagnosis as I do.

Still, I assume that we are not going from 0 to full force on October, 2014. I assume there will be a transition where more and more specific codes are required to get payment promptly.

We may have to sell out to hospitals just to get coding help. A lot of borderline broke doctors out there.



Dan
Rheumatology
psundwall #53379 04/16/2013 9:09 PM
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The other issue is that the rest of the world is getting ready to go to ICD_11: we should delay and just go to that if needed. (IFFF!)


Chris
Living the Dream in Alaska
psundwall #53415 04/18/2013 1:24 PM
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It is going to cost the insurance companies a bundle to go to ICD-10. Undoubtedly, since their business model is different from ours, they may find some way to recoup their costs (like slowing down payment). But it won't really be a very satisfactory situation where everyone is angry all the time, so they can't do that on a routine basis.

My simple analysis of any problem always starts with "who profits, who pays?"

Clearly the patients don't gain anything from this.
And I can't see any way it will help me....

In this case, it is the "coding community" who profits- a subset of the administrative department, not the clinical department.
So once again, it is all about increased administrative control. They will enforce the new system as loosely or tightly as is necessary to maintain the desired trajectory: total domination of the clinical milieu.


Tom Duncan
Family Practice
Astoria OR

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