ICD-10: What's the Point?


Yes, there is a point to ICD-10. But you may not like it.

Fam Pract Manag. 2013 Nov-Dec;20(6):4.

ICD-10. The term strikes fear in the hearts of clinicians. First, there was HIPAA, then meaningful use, and now this. “When are all these new rules going to stop?” you ask. “I can't take it anymore,” you plead.

Well, your pleas will fall on deaf ears, Dr. Kenneth Beckman assures us in his article on ICD-10 in this issue. He says, “ICD-10 is coming. The scheduled date of arrival is Oct. 1, 2014, and there does not appear to be any potential for further delays.” You just need to suck it up and get with the program.

OK. He doesn't say that. I paraphrased a little bit. But even if ICD-10 is unavoidable, you may be wondering, “Why are they doing this to us?”

They, also known as the federal government, assert several benefits for ICD-10. ICD-9 is outdated, they say. ICD-10 has codes more consistent with modern practice. Its greater specificity will help in quality measurement, public health research, health policy planning, fraud detection, and risk adjustment for quality-based reimbursement. Oh and by the way, we have no room for new codes in some chapters of ICD-9.

“Great,” you're thinking, “but will this help me improve the care of the patient in front of me?” The short answer is no. Sadly, the benefits are not targeted at us – the clinicians. ICD-10 will take a lot of work and money to implement. We can all plan on going to ICD-10 classes sometime in 2014. We can all plan on messed up payments or perhaps no payments at all for a time after Oct. 1, 2014. It will be a great excuse for insurers to reject our claims and then blame it on their computer systems. All the edits in their systems saying what they will and will not pay for will have to change. Mistakes will be made. Prepare for this. Put a lot of cash aside for October and November of 2014. You might not be able to pay your bills otherwise.

ICD-10 does have a bright side, however. It will be a source of endless medical humor. One of my favorite new codes is V91.07, “Burn due to water-skis on fire.” I hate when that happens. We don't see a lot of that in the Arizona desert where I live, but I bet the docs in Florida have to contend with that all the time.

You should also hope that you don't work, live, or sleep with any people classifiable as F46.1, “Bizarre personal appearance.”

I hope I'm wrong about ICD-10. I hope it all goes off without a hitch. But the Boy Scout in me says, “Be prepared.”


Copyright © 2013 by the American Academy of Family Physicians.
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