Updated on: March 14, 2016

2015: What’s in a Year?

Original story posted on: January 5, 2015

A new year can bring about many changes, and you never really know how all those changes can pan out. One thing is for sure in looking back, however: many of us were surprised by the ICD-10 delay.


What side of the fence you stood on surely determined your thoughts of whether it was welcomed or not. Whether you were for or against a delay, however, we learned a lot in a short period of time. Here are four top things we have learned from the delay – and if you haven’t started to prepare for ICD-10 yet, then they are also great learning lessons/best practices from which you can benefit.

The extra time created by the delay allowed us to debunk some of the ICfD-10 myths. Since there were many in the industry that felt well-prepared prior to the delay, we were also able to get some hard facts.

  • For most providers, the cost of preparation falls well under the speculated cost. On average, AAPC studies indicated a cost of $3,500 per provider. Unless you need significant technology updates, you can control many of your expenses. There are many places you can also get low-cost (and sometimes even no-cost) education.
  • Productivity will not take years to return to normal. Clients trained by AAPC have demonstrated the return of productivity after daily use of the new codes within a few weeks. If you got training too early because of the delay, make sure you continue training with refreshers if you are not performing dual coding. Our coders are true rock stars: they embraced the upcoming change, increased their necessary skill sets, and now many of them are assisting their physicians with documentation improvement.
  • If you haven’t treated the patient burned on flaming water skis, he or she won’t miraculously show up at your doorstep just because there is a code for that. It doesn't matter what size the book is, it will not change the patients you currently treat. Most practices won’t require the use of external cause codes; if you didn't use them in ICD-9, you probably won’t need them in ICD-10. CMS currently does not require the reporting of them.
  • Unspecified codes count. There are legitimate reasons to use them, but just know: once you make the clinical determination of the patient’s condition, make sure you transition the code and report the most specific one. Otherwise, every time you submit a claim on that patient you are basically saying “I still don’t know what is wrong with the patient.”

Unfortunately, we have many in the industry who have not yet reengaged in ICD-10 planning, with some indicating they will start back up in early 2015 and others still unsure if they want to engage (as they worry about putting money into something that could be delayed again). If you have not reengaged, figure out what you can do now that will improve the quality in your practice; that is, determine what is guaranteed to bring you many steps closer to being prepared for the new codes. Also, don’t wait for your vendors to tell you what they are going to do for you; reach out to them and figure out how long it will take and how costly upgrades will be for you.

So far, early testing has been positive, so make sure you stay on top of efforts. There will be increased testing beginning in January, and the lessons we learn from this will be vital to making the transition successful.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.

Rhonda Buckholtz is the vice president of practice optimization for Eye Care Leaders. She has more than 25 years of experience in healthcare, working in the management, reimbursement, billing, and coding sectors, in addition to being an instructor. She is a past co-chair for the WEDI ICD-10 Implementation Workgroup, Advanced Payment Models Workgroup and has provided testimony ongoing for ICD-10 and standardization of data for NCVHS. Rhonda spends her time on practice optimization for Eye Care Leaders by providing transformational services and revenue integrity for Ophthalmology practices. She was instrumental in developing the Certified Ophthalmology Professional Coder (COPC) exam and curriculum for the AAPC. Rhonda is a member of the ICD10monitor editorial board and makes frequent appearances on Talk Ten Tuesdays.