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ICD 10 Implementation: Challenges and Strategies

A doctor strategizes ICD 10 implementation challenges.ICD 10 implementation is as much about being flexible and able to adjust as it is having a solid plan. Many clinics got off to the right start by creating a team or leader to instigate, support, and monitor the ICD 10 changeover that was required on October 1st. Other strategies to tackle this challenge included training, increased payer communication, and outsourcing. But no matter the amount of preparation, ICD 10 implementation is bound to have a few initial bumps.

Likely, your practice has already felt some of these bumps after submitting your first batch or two of ICD 10 claims:

  • software hiccups
  • changes in reimbursement patterns
  • insurance coverage alterations
  • cash flow disruption
  • increased documentation for better accuracy

In fact, the increased need for documentation to code is estimated to be taking 15-20% more time for doctors alone. That translates into a total of 3-4% more of their time spent on recording patient notes. The increase in workload has caused some physicians to demand higher pay at the risk of transferring to another clinic.

Another large problem that practices have faced has come from the ICD 10 code directory itself. Because there are now almost 70,000 diagnostic codes and almost 90,000 procedural codes, all notes must be extremely specific. But what if the diagnosis or procedure is not so specific? Or your team is still unsure which specific information is relevant?

The best strategy for notes is to format the electronic health record (EHR) with structured drop-down boxes alongside a place to write a narrative note. That way, you can add depth to the patient’s story including conjectures for what ails them. Make sure to also build a progress note for patients with an extended condition or stay.

Additionally, be aware that the ‘grace period’ offered in some cases does provide a little wiggle room for these challenges. However, you still must maintain the correct first three digits of a code to ensure that Medicare will not deny a claim outright.

ICD 10 implementation didn’t end on October 1st, and it may not end for a few more months or even years. The program will continue to change, and hopefully your clinic will continue to grow with the changes and meet the challenges head-on to maintain positive productivity and revenue. If you would like assistance with practice management or your billing cycle during this time or down the road, trust Billing Advantage to help you come out on top.


Donna Whipple Donna Whipple

Donna Whipple, Psy.D. is a clinical psychologist with over 30 years of management experience. She has particular interest and expertise in HIPAA and ethical treatment and business practices in a changing high tech industry. She has a particular talent in boiling down complex regulations so providers can understand and comply with them. As co-owner of Billing Advantage Inc., Donna is involved in all aspects of the company but her particular contributions to the business is in mentoring upper level managers and helping them be more effective in their leadership.


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