Three urologists discussing their early experiences with ICD-10 make it clear that the transition hasn't been the disaster predicted by some.
Dr. Richter"The biggest benefit of ICD-10 from my perspective is the specificity and what that can do-that really increases the ability to search for codes and diagnoses for research purposes and analytical purposes more accurately. So I like the idea of it and I think it’s a good move.
As far as how it’s gone in the office, the switchover has been very smooth but I think that’s because we have electronic billing. Some of the electronic billing allows you to easily search for the code you want through the hundreds and hundreds of codes that are out there. The search process is quick and pretty flawless. If I were doing paper billing and had to look up the codes and transpose them onto a paper bill, then I think the whole process would be a lot more tedious.
I think it was a smoother transition than I expected, again because I’m doing electronic billing. By putting in even simple words to describe the diagnosis, all the codes from ICD-10 from which you can appropriately choose are easily populated. Then, with just a click, the diagnosis is assigned for that patient. So the process has gone smoothly so far.”
Lee Ann Richter, MD
Next: "My experience with switching over to the ICD-10 has actually been indifferent."
"My experience with switching over to the ICD-10 has actually been indifferent. Initially, for the first couple weeks, it was challenging looking up the new codes, but from the urology perspective the ICD-10 codes haven’t changed significantly and looking them up is not too difficult. So for the first couple weeks, it was relatively cumbersome but now it’s probably about the same as with the ICD-9.
We have electronic billing, but we don’t have EMR yet. The biller in my office took a course before the conversion and she’s done great, and she’s had no issues with either billing or reimbursement.
I had expected more problems just because of the transition to the greater number of codes and the environment people were talking about; we thought it would be more challenging but actually the transition was not that bad.
Remember when the Y2K came out and the world was going to end? It’s very similar to that. The ICD-10 was implemented and nothing changed.”
David J. Rosenberg
Next: "We have EMR so that made it easier, but it was much easier than we expected."
"The transition to the ICD-10 was met with a lot of skepticism because in general, physicians are skeptical about anything that’s new. In essence, the ICD-10 is much more comprehensive than the ICD-9, and the coding is more accurate. As far as being able to follow issues with patient care for the future, I think it’s going to be much better. Initially, there may be growing pains, like everyone experienced with EMR. In the long run, I think there was a lot of hype about potential problems transitioning to the ICD-10 rather than actual reality, especially if doctors were not EMR capable.
We have EMR so that made it easier, but it was much easier than we expected. Everything was all laid out prior to the start. A lot of the hospitals are transitioned to it, and I think we’re going to see even more evolution to make it more comprehensive.
If you look at other parts of the world, I have practiced in Europe, and places like Denmark, Sweden, and others have everything very specific as far as ICD-10 is concerned. We are learning from the European experience and their ability to tap easily into their database. They can see how many radical prostatectomies have been done at a certain stage of cancer.
We are going through growing pains in America because we’re novices. But because we’re able to see what Europe is already doing, it’s making it easier for us, especially in patient care. It’s like the credit cards now here in the United States that have a chip. They’ve had that in Europe for years. In Italy, for example, your entire medical record is on that chip. You swipe it in the computer and out comes your entire medical record. We’re moving into that smart medicine era here in America.”
Arnaldo Trabucco, MD
Fort Mohave, AZ
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