Physician Practice

ICD-10 coding not being put to optimal use

Physician Practice Insider, July 21, 2017

In nearly two years since practices adopted the ICD-10 code set, billing and coding experts say the transition was fairly smooth but that, in most cases, the codes are not being put to their intended use.

The October 2015 transition from the ICD-9 code set (with about 14,000 codes) to the ICD-10 set (with more than 69,000) was fraught with concerns about a potential landslide of claim denials for practices that weren’t prepared. But for the most part, those concerns were never realized.

“It was a lot like Y2K, where everyone was concerned that planes would be falling out of the sky and the world would come to an end,” says Deborah Hill, a managing consultant with the Coker Group in Alpharetta, Georgia. “But in the end, it wasn’t a big deal.”

Hill notes that, to a surprising degree, the transition to ICD-10 quickly segued into business as usual for many providers and coders. But the smoothness of the transition isn’t all good news, she notes.

“Many practices simply created a new set of shortcuts to replace the old set of shortcuts” instead of learning the proper way to use the ICD-10 codes, says Hill. “If everyone were doing this 100% accurately, it would have been a much bigger deal than it is. But providers are just finding new shortcuts and doing just enough to stay under the radar.”

This article was originally published in Physician Practice Perspectives. Subscribers can read the full article in the July 2017 issue.


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