ICD-10: Possible fixes

The main problem with ICD-10 in the U.S. is its flawed implementation and huge impact on every aspect of the health care system, according to W. Jeff Terry, Sr., MD. For physicians who have small practices and might still be struggling with EMRs and other government regulations, ICD-10 implementation could be the last straw, he says.

Solutions, according to Dr. Terry, include:

• Uncouple the ICD diagnosis code from the CPT payment code, so physicians’ payments wouldn’t hinge on correct coding. This, he says, is the most important fix.

• Use ICD-9 and ICD-10 concurrently for the first year, until the glitches are worked out of the system.

• Adopt ICD-10 as scheduled, on Oct. 1, 2015, but have assurance from CMS that it will not penalize physicians for coding mistakes in the first year. The concern is whether other payers would honor the grace period.

• Bypass ICD-10 and transition to ICD-11, which is scheduled to come out in 2017 in its raw version. “We’re going to spend all this money on ICD-10. Then, CMS is going to mandate that we use ICD-11 in 5 to 10 years,” Dr. Terry said.

Jumping to ICD-11 would be impossible, according to Jonathan Rubenstein, MD. “ICD-11 won’t be ready for several years, and it takes several years to clinically modify the newest version of ICD for clinical use here in the U.S.,” Dr. Rubenstein said. “And we need ICD-10 to be able to transition to ICD-11.”

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