Three ICD-10 Myths and Facts That Every ENT Must Know

dr_EHR / February 4, 2016

The curtains are falling on ICD-9 and in its place ICD-10 will be playing the lead role come October 01, 2015. At least that’s the version of the story the CMS and other government healthcare organizations are going by. It’s a version we should believe, considering even medical associations such as the American Medical Association have not vehemently opposed the new coding structure as they did in yesteryears. If this is the status quo, what does it mean for you as an ENT? How will ICD-10 impact your otolaryngology practice and how you are currently coding? In a nutshell, a lot. Let’s go through three of the top myths and facts about ICD-10 that you need to know as an ENT, and how they can affect your practice.

1 Coding

The code base for ICD-10 is over four times the size of the ICD-9 code base so we are looking at a substantial addition of codes that you will need to report as you comply with ICD-10. The current myth going around is that these codes are just too many to make any sense. As a whole, yes. But for an ENT, for example, your only concern is the codes that apply to your specialty. So what if there are a million others that do not apply to you? When you look at it this way, the total impact of the rise in ICD codes on specialty practices will be significantly less than what is assumed at the moment.

2 Costs

With every transition comes a concomitant cost of switching. ICD-10 is no exception. If you look at the requirements to comply with ICD-10, you quickly appreciate that cost implications factor into the entire process. Now as far as myths go, the myth concerning cost is that the government through the CMS will intervene and offer some financial incentive to help offset what practices use when transitioning. Sadly, this is but that, a myth. Unlike in past transitions where the government stepped in to financially ease the transition of the day, this time, doctors such as yourself will have to pay, out of their pocket, for the entire cost of switching.

3 Mapping

It would have been easy and very convenient if all codes from ICD-9 could be mapped to ICD-10 with a mapping tool accurately to make the transition easier. This, unfortunately, is only part myth and part truth. The Myth part is that it is impossible to map all the ICD-9 codes onto their corresponding ICD-10 codes for a number of reasons. First is that the ICD-10 code structure differs from ICD-9 by two digits. Second is that this addition of digits occasioned the increased granularity of codes, something that ICD-9 did not have. The result is a rather incongruent set of codes when set side by side. The truth part is that some innovative providers have created cross-walk charts for ENTs that “map” their most frequently used ICD-9 codes to ICD-10. This hack is at least a step in the right direction towards helping ENTs relate the codes they used in ICD-9 to those in ICD-10.

For ENTs, ICD-10 represents a huge leap into the future where the codes will now support more advanced medical diagnostic techniques and outcomes. There may be some initial pain in transitioning but the outcome is anticipated to benefit the entire medical fraternity and medicine as a science.