ICD-10 Myths Debunked
By Heather Bettridge Texas Medicine February 2012

Symposium on ICD-10 Conversion – February 2012

Tex Med. 2012;108(2):37.

By Heather Bettridge, CPC, CPMA

Faced with the Oct. 1, 2013, ICD-10 implementation deadline, physicians have a unique opportunity to embrace the conversion and position themselves with an indisputable advantage – knowledge – before then.

 By beginning education now and gradually incorporating changes, physicians can prepare their practices for the least amount of chaos and negative impact on the revenue cycle as possible.

During their preparation, physicians should avoid investing time or thought on these looming ICD-10 myths and misconceptions.

Following are eight of the most widespread ICD-10 myths:  

1. The Centers for Medicare & Medicaid Services (CMS) will postpone the date for ICD-10 implementation. The deadline for compliance with ICD-10 is Oct. 1, 2013. CMS has not indicated any plans to change this date or extend a grace period. (However, in November, the American Medical Association adopted a Texas Medical Association resolution directing AMA to ask CMS to stop implementation of ICD-10.) Do not report any ICD-9 codes for services provided on or after Oct. 1, 2013. Any claims received with these old codes will not be paid.
2. Physicians will have to document in a completely different way. Documentation requirements for ICD-10 will vary from ICD-9; however, much of the detail necessary to code using the ICD-10 coding system is already being documented. Documentation indicating the place and type of injury, the sequencing of the encounter, etc., will now be required, not optional, as it is now using ICD-9. When documentation does not support using a code with a higher level of specificity, physicians may continue to use “other specified” (NEC) and “unspecified” (NOS) codes. 
3. The process of coding will be much more difficult. Because ICD-10 codes have greater specificity and a more logical code structure, finding the appropriate codes will be easier than before. CMS anticipates the development of robust coding tools that should ease the code selection process and make it faster.
4. Other countries used ICD-10 for years, and it is already out of date. ICD-10 has been revised through the years to incorporate advancements in medicine and changes in technology. ICD-10 already significantly exceeds ICD-9 in the number of available codes and disease classifications. While ICD-9 was nearing maximum capacity, ICD-10 can add new codes through code structure improvements and the use of "placeholders." 
5. Superbills will be cumbersome and nine pages long. Although one-page comprehensive superbills will become obsolete with the implementation of ICD-10, nine-page superbills would be impractical to use. As long as physicians customize their superbills to their specialty and include the most frequently reported codes, superbills need not be any longer than before.
6. Unnecessary testing will be performed to assign a code. Similar to coding in the ICD-9 system, physicians may report codes for signs and symptoms if a diagnosis cannot be established during a patient encounter. 
7. ICD-10-PCS (Procedure Coding System) will be used to code all services. Procedures and services will be coded according to the setting in which the encounter took place. ICD-10-PCS will be used to code inpatient/hospital services. The Current Procedural Terminology (CPT) book will continue to be used for outpatient procedures and services. ICD-10-PCS will not replace CPT codes.
8. A practice must have an electronic medical record system to use ICD-10 codes. The ICD-10 coding system is not dependent on electronic hardware or software. All medical practices, whether using paper or electronic medical records, will be required to use ICD-10 codes as of Oct. 1, 2013.

Blindly accepting these myths as truths may cost practices time, money, and the opportunity to use their ICD-10 conversion and education to sustain and advance their practice viability. By debunking common myths and exposing physicians to the facts now, come Oct. 1, 2013, ICD-10 will be less intimidating. A proactive and strategic approach to the conversion will arm physicians with knowledge and better position them to achieve success with implementation. 

Heather Bettridge is a practice management consultant with Texas Medical Association Practice Consulting.

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