United States: There’s A Code For That: Counting Down To ICD-10 And A Poem To Help You Remember!

~We wrote down this poem,
To help you recall,
That changes are coming
coding this fall.~

On October 1, 2014, all HIPAA-covered persons and entities must be compliant with the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM and ICD-10-PCS, respectively).  Despite numerous extensions of this compliance date (which was originally set to be October 1, 2011), vocal objection from industry stakeholders and more than thirty years of reliance on ICD-9, the Centers for Medicare & Medicaid Services (CMS) has indicated that the October deadline is firm, and affected stakeholders should not expect further delay.

~These codes are specific.
They're very exact.
We'll code a
As a matter of fact,
If you should enter
His digestive tract.
But try to forgive him,
If you're left intact,
'Cause haven't we all
From time to time snacked?
Who's never broken
A dieting pact?!~

 The Why

According to CMS, the impetus for making the transition to ICD-10 is mainly two-fold.  First, CMS posits that ICD-9 codes provide limited data about patients' medical conditions and hospital inpatient procedures.  For example, ICD-9 is more than three decades old and contains no codes for more modern treatment procedures, e.g., arthroscopy, among others.  Also, ICD-9 is considered "outdated and obsolete," "inconsistent with current medical practices," and its structure "limits the number of new codes that can be created," as many ICD-9 categories are already full.  Second, CMS argues that ICD-10 codes allow for greater specificity and exactness in describing a patient's diagnosis and in classifying inpatient procedures. That is, ICD-10 will "accommodate newly developed diagnoses and procedures, innovations in technology and treatment, performance-based payment systems, and more accurate billing."  Additionally, because ICD-10 will "make the billing process more streamlined and efficient," regulators will be, according to CMS, better able to detect fraud.

~Say that your
golf ball
Should wind up astray,
(caused by your golf swing,
and handicapped play),
and then should it land
on your neighbor's soir้e?
Such that you're shouting,
"#$%&!!!  Are you ok??"
But he's exclaiming,
"Boy – You're gonna pay!!!"
While shaking his fist
And a ruined souffl้,
With all of his guests
Now in disarray,
One of whom needs,
An emergent x-ray???
Please, don't you worry!!
You know what I'll say:
Your doctor can code it!
It's easy that way!!!~

The Why Not

The American Medical Association has been among the more vocal in opposing implementation of
ICD-10 and not without reason.  Per the AMA's February 12 letter to the Secretary of the U.S. Department of Health and Human Services, the "broad use of ICD-10 codes for determining reimbursement, coding in all health care settings, and health care coverage has not been done in other countries, making the U.S. implementation unprecedented."  Moreover, affected practitioners must "contend with 68,000 diagnosis codes," which represents "a five-fold increase from the approximately 13,000 diagnosis codes in use today."

Two of the AMA's primary arguments against ICD-10 are (1) it is financially disastrous for physicians, and (2) it impedes physician progress in a performance-based environment.  In support of the first contention, AMA refers the reader to the Nachimson Advisors Study, which estimates that the cost of implementing ICD-10 for smaller physician practices will range from $56,639 to $226,105.  In support of the second contention, AMA argues that "[p]hysicians' ability to purchase technology and participate in new payment and delivery reform models that improve care coordination and reduce costs will be stifled if their resources are diverted away" for purposes of meeting the more stringent coding requirements of ICD-10.  For further information regarding AMA grounds for opposing ICD-10, please click here.

~Should you encounter,
orca... or two,
One that determines,
The menu reads "you,"
Or vicious
At your local zoo?
Or rollick with
That carry the
You guessed her, Chester,
'Cause we'll code that, too.

What's that you say?
A dolphin instead?
A dolphin – he bit you??
Right there, on your head?
(Oh, just the thought,
it fills me with dread!)
Let us all hope,
this isn't widespread!!!
But here, use this code.
Go on, go ahead.~

Conclusion and the Rest of Our Rhyme

Though well-intentioned, the move to ICD-10 is not without controversy and has been the source of headlines ranging from "ICD-10-CM:  It Is NOT All that Bad" to "New Rule Creates Avalanche of Time-Wasting Paperwork for Doctors."  But regardless of these divergent views, CMS has indicated that it is serious about the October 1, 2014, compliance deadline, and we have advised our clients to prepare adequately for implementation to lessen headaches as this date approaches.  To assist in preparation, CMS has created a provider resource website that contains further implementation guides, checklists and timelines for different practices (e.g., large practices, small and medium-sized practices and small hospitals), and Medscape Education modules, as well as conferences, meetings and webinars.

With all this said, however, we understand the perspective of many practitioners who have found humor in the specificity of some of the new codes, and to help keep ICD-10 compliance on your mind, we have created this light-hearted poem (the remainder of which appears below).  Our poem contains hyperlinks to ICD-10 codes, and we hope you enjoy it.

As always, should you have any questions about ICD-10 or any other legal or business matters affecting your practice, please feel free to contact any member of our healthcare industry team.

~Sucked in the engine
Of an Embraer jet
Skis caught on fire,
Despite being wet?
Assailed by a parrot
When seeing the vet?
Or gored by a goat,
Not seen as a threat
Maimed by the opera
While you're at the Met?
Or stabbed while crocheting?
We'll code it, you bet!!!

Why, it's got your back!!
It even can code
A sea lion attack!!
Or a black eye
From a falling kayak.

Say you decide
To head to the moon,
To feel weightlessness,
Like a human-balloon?
And while you're floating,
One clear afternoon,
Sadly you suffer...
(How inopportune!),
Attack of a rabid,

Wayward moon rocks!!!
A fall while in
Or the
sprain of an ankle,
Requiring a brace?
Struck by a turtle,
Right there, on your face?
Your doctor can code it,
When doing your case.

S'pose that you quarrel
With your younger brother.
You poke, and you tease,
And you vex one another?
We can still code it.
that with your mother!!

Let's say your in-laws,
Harm you, or vice versa,
Well, don't just sit there!
Disarmed by inertia!

Head to your doctor,
Go there, right away!
Your doctor can code
These problems all day.

Or should you handle
A venomous frog,
Or land in the jaws
Killer, the dog?
Yes, you can code it.
Remember our blog!!!!~

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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