Surprise! Providers report smooth transition to ICD-10

Friday, December 11, 2015

YARMOUTH, Maine – The recent transition to ICD-10 codes hasn’t been as bad as they thought, the respondents to a recent HME Newspoll say.

The keys to what has been mostly a smooth transition for 64% of respondents: a prepared staff and good software.

“The challenge for us was being certain that our staff was fully trained before Oct. 1,” said John Reed, CEO of Walnut Medical Services in Johnstown, Pa. “We met that goal and hoped that our referral sources were prepared also. So far we are getting paid and encountering few problems.”

The transition to ICD-10 has meant working with a significantly more specific and expanded code set—68,000 codes vs. the previous 13,000.

A number of respondents credited software vendors like Brightree and TeamDME! for doing much of the heavy lifting to make sure there were few hiccups.

“Our software vendor made the transition extremely easy by converting the GEM (general equivalence mapping) codes for us, and automatically adding them to patient records and unprocessed transactions,” said Bruce Brothis, president of Allegient Billing & Consulting in Elizabeth, Colo. “Edits were also added to ensure the right version was transmitted for the affected DOS. There have been virtually no interruptions short of getting the correct ICD-10 codes from the docs for non-GEM translations.”

One concern about the transition that has played out for a number of respondents: Physicians who aren’t up to speed.

“The hard part has been getting the physicians to provide the correct codes, or the chart notes so we can code the claim ourselves,” said H.S. Moore, a billing manager at Medicor in Salt Lake City.

But for some respondents, the transition has helped, not harmed, their efforts to get proper documentation from physicians.

“The biggest surprise (and benefit) has been that physicians are now sending orders with the ICD-10 codes when previously we could barely get enough information to find the ICD-9 codes ourselves,” said Lori Sears, owner of Active Home Medical Supply in Lapeer, Mich. “I no longer have to fight for the information needed to get things like ‘foot fracture’ or ‘gait instability’ properly coded.”

Related stories:

ICD-10: No big deal—yet

ICD-10: Providers brace for disruptions from physicians, payers

Expect challenges from ICD-10 transition