Coalition for ICD-10 finds success with new codes is linked to practice size

Coalition for ICD-10 finds success with new codes is linked to practice size

It has been nearly a month since the implementation of the ICD-10 codes. The federal government and stakeholders throughout the industry have anxiously waited to see how providers would handle the new coding set and whether the transition was going to mean major setbacks for practices. A recent report published by the Coalition for ICD-10 suggests that the success practices are seeing is linked to their size.

Coalition for ICD-10 reports mixed success
The majority of the practices that have reported smooth transitions are on the bigger side, while most of the small practices that have made reports to the coalition have had difficulty. For example, many of the coalition's members are part of larger practices and have mentioned very few speed bumps during the switch. A lot of the larger practices have noted that they were able to effectively prepare for the major transition because they updated their systems to efficient electronic health records. They also carefully planned their approach to the new codes. 

Many larger practices also noted that they implemented the ICD-10 codes before Oct. 1, which gave them time to become familiar with them. Others, such as Blue Cross Blue Shield of Michigan, reported overall success, but mentioned that there were a few inevitable obstacles they are still working on smoothing out. 

"BCBSM's ICD-10 implementation went very smoothly," the insurer explained. "Call center volumes and overall inquiries are very low. Professional and facility claims are processing as expected. A few issues noted, which we are resolving, but nothing major to report." 

While this seemed to be the case for most larger practices, smaller organizations are struggling with a few specific aspects of the ICD-10 implementation.

Small practices await reimbursements
One problem is that smaller practices, specifically family-run practices, had fewer staff members and resources to guide them as they prepared for the implementation date and throughout the transition.

Another issue that small practices have come across is their inability to reach the Centers for Medicare and Medicaid Services during the transition from ICD-9 to ICD-10. A large portion of their revenue comes from the CMS but, according to recent reports, the agency has been impossible to get in touch with. Physicians have pointed out that their billers have constantly tried to reach the CMS, but cannot because the agency's website has been down.

As a result, small practices are not receiving their usual CMS payments, which generally account for at least 30 percent of their revenue. This can have lasting setbacks on these practices because it may be challenging to go without that much money. However, larger practices can generally go without this payment for a few months without facing major issues.

There is still hope for small practices, however, as the CMS has set a deadline for distributing ICD-10 reimbursements. The agency has claimed that it will make payments within the first 30 days of the ICD-10 transition. There are still a few days until this deadline has passed, so physicians are anxiously awaiting to see if they will receive their reimbursement in October.

Members from the Fellow of the American Academy of Family Practice have reported to the Coalition for ICD-10 that they have been having a hard time with the heavier workload as well. EHR Intelligence noted that Linda Girgis, M.D., of the FAAFP, explained that she has a family practice that is experiencing a drastically larger workload, as she is now responsible for updating all of her patient problem lists to the ICD-10 codes. This adds a lot more time to her usual work day.

Although there are mixed reports on the industry's success with the new codes, the majority of practices, hospitals and organizations seem to be handling the transition without any major setbacks reported so far.