Friday, February 17, 2012

ICD-10 Delay( WARNING: This is Complicated Stuff)

I attempted to rise, but was not able to stir: for as I happened to lie on my back, I found my arms and legs were strongly fastened on each side to the ground; and my hair, which was long and thick, tied down I the same manner. I likewise felt several slender ligatures across my body, from my armpits to my thighs. I could only look upwards, the sun began to grow hot, and the light offended mine eyes. I heard a confused noise about me, but in the posture I lay, could see nothing except the sky.

Jonathon Swift (1667-1745), Gulliver's Travels

February 17, 2012 - Before yesterday, government’s bureaucratic Lilliputians have been planning to tie down physicians with another mandate, the ICD-10 code.

Thank goodness, Kathleen Sebelius, HHS secretary, has announced physicians won’t have to comply for the time being with ICD-10, short for International Classification of Diseases 10th edition”.

ICD-10 was to replace ICD-9, the coding system by which physicians are now paid.

The new ICD-10 code would require physicians to completely revamp their practice management systems. It would distract from patient care. It would come at great cost and confusion. It would take overhauling and reprogramming existing computer programs. It would drive physicians out of private practice into the arms of large organizations with technological and administrative resources.

According to HFMA (Health Management Finance Association), carrying out the transition to ICD-10 would take the following steps.

--Establishing a project management team

--Creating an implementation plan

--Producing and projecting a timeline

--Preparing a gap analysis for each department or system

--Calculating and preparing for impact on the revenue cycle


As I forewarned in my blog title, this is complicated. Unfunded government mandates cost money, time, energy and distract from patient care.

These mandates, I submit, require a tremendous expenditure of time, money, and energy to adjust to bureaucratic demands. About 70% of medical practices have 10 or less members. These practices do not usually have the money, time, or resources to prepare for or to carry out these actions.

Other Complicated or Anticipated Mandates

The delay allays tremendous anxiety among physician and physician practice managers’already struggling to rise above other Lilliputian mandates.

• Electronic health records, to be rewarded or punished on basis of “meaningful use

• Transition to 5010 HIPPA Standards

• The uncertain legal status of the Accountable Care Act, presumably to be resolved by the Supreme Court in June.

• The concentrated push for Accountable Care Organizations

• Constant calls for bundled billings and doing away with fee-for-service.

• Incessant chatter about the matter of new modes of physician practice.

Doctors have enough on their bureaucratic plate to tie them down and to distract them from patient care.

Tweet: CMS has delayed its unfunded ICD-10 coding mandate which would require revamping of physician management systems at great cost and confusion.


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