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Friday Oct 03, 2014

The Countdown Begins: One Year to ICD-10

One year. That's how long we have to get ready for the official implementation of ICD-10. Oct. 1, 2015, is the day we have been nervously awaiting since July, when CMS confirmed that as the revised compliance date for the new coding system.

Later this month, the Academy will offer CME courses related to ICD-10 to help us prepare during the AAFP Assembly in Washington. Will your practice be ready?

Every time I read an article about ICD-10, I wonder how small practices like mine will survive this new hurdle. A study(www.ama-assn.org) conducted by Nachimson Advisors and published by the AMA estimated that small practices could suffer costs between $56,000 and more than $226,000. A large practice's financial impact is estimated to range from $2 million to $8 million. These figures are three times what was estimated by the same research group just five years ago.

ICD-10 has more than 68,000 diagnostic codes compared with ICD-9, which has a little more than 14,000 diagnostic codes. This is a significant shift for family medicine. The differentiation of right, left and bilateral accounts for about 40 percent of the increase in codes for ICD-10. Initial versus subsequent diagnosis codes might create an obstacle for the busy physician but will ultimately be helpful for tracking purposes.

According to the American Health Information Management Association, the new coding system will result in higher-quality data that can improve measures of quality and performance, provide "increased sensitivity" to reimbursement methodologies, and help strengthen public health surveillance.

But how do we get there? Updates to my practice's electronic health record (EHR) system have allowed us to "bridge" to ICD-10 for the past eight months. Testing and payment disruptions are variables that are impossible for me to anticipate, and every consultant we talk to offers a different opinion as we try to assess how to proceed.

In my search for assistance on the web, I found "The Road to 10: The Small Physician Practice's Route to ICD-10," an online resource(www.roadto10.org) an online resource to help small physician practices transition to ICD-10. This tool was developed by CMS in collaboration with industry partners. It allows a small clinical practice to create a customized action plan for ICD-10 readiness and preparation. It provides a five-step action plan that covers planning, training staff, updating systems and processes, engaging partners, and testing.

Although that resource is geared to small practices, the AAFP and its journal Family Practice Management have resources that can help practices regardless of size.

In addition, CMS recently announced the dates that it will do readiness testing using ICD-10 codes.  What are you doing to prepare?

Rebecca Jaffe, M.D., M.P.H., is a member of the AAFP Board of Directors.

Posted at 03:50PM Oct 03, 2014 by Rebecca Jaffe, M.D.

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