Updated on: March 14, 2016

ICD-10 Anxiety versus Concussion and Youth Sports

Original story posted on: March 18, 2013

My employer, the ChiroCode Institute, has published the ChiroCode Deskbook for the last 21 years. It is the "bible" of billing and coding for chiropractic physicians.


Last year, however, we finally signed an agreement to merge it with the American Chiropractic Association's (ACA) coding book. This marriage was the result of a very long and cautious courtship. The ACA is the largest professional organization for doctors of chiropractic medicine, and it sets standards for patient care and ethics, lobbies the government on behalf of the profession, and supports research. Every spring, it also holds a National Chiropractic Legislative Conference in Washington, D.C. Since we are still in the honeymoon phase of our relationship, I was invited this year to speak at the educational symposium on the subject of ICD-10 preparation.

When I arrived at the Capital Hilton, just two blocks from the White House, I scanned the program to see how my presentation appeared. It simply said "ICD-9-10.” I was disappointed to see no catchy phrases or scare tactics meant to frighten the doctors into attending my session. I also noticed that the other session scheduled at the same time as mine was titled "Concussion and Youth Sports." I find it hard to imagine a scenario in which anyone would choose "ICD-9-10" over "Concussion and Youth Sports."

Indeed, chiropractic physicians, much like other providers or specialists, have buried their heads in the sand with regard to the impending coding change.

The introduction and conclusion of my presentation included comics about procrastination. As such, I expected to find myself speaking before a nearly empty room. As I began, there were actually only a handful of physicians, but as people finished their lunches, they began to stream in, and by the end of my presentation the room was nearly full. I like to think it was because the word got out subconsciously and everyone was drawn to my amazing training skills.

In every presentation I do on ICD-10, I like to survey my audience to find out what their perceptions are. I explain to them that my goal is to reduce their ICD-10 anxiety by at least 50 percent. Before we began in Washington, D.C., nearly everyone had a negative perception and felt that ICD-10 was going to be a real pain. But I pointed out that we survived Y2K, so we probably will survive Oct. 1, 2014.

My presentations review the history and limitations of ICD-9, and then go into the structure of ICD-10. My goal is to help attendees see that ICD-10 really is better, and that the hassle is worth it. I then introduce cross-walking common ICD-9 codes for chiropractors, starting with GEMs, followed by deeper research. If they don't want to dig on their own, I send them to my articles published on ICD10monitor.com.

It is important for people in my workshops to have tools to use for follow-up. Two years ago, the ChiroCode Institute released a book titled "Complete and Easy ICD-10 Coding for Chiropractic" – the only one of its kind. It is the basis for most of my chiropractic-centric information. The last piece of my presentation typically is focused on implementation steps, which include budget considerations, cross-walking, forms, vendor relationships, and internal testing.

There are some great videos on YouTube titled "Yeah, there's a code for that" that were created by a company called FindACode. They mock some of the more outrageous new ICD-10 codes, and I like to use them to keep the interest of my audience. Somewhat to my surprise, my audience on this day was highly engaged. There were points during my session where the laughter from my meeting room must have been overheard across the hall, where all those poor saps were learning about "Concussion and Youth Sports."

In the end, I believe my purpose was met: A few more chiropractic physicians had reduced their "ICD-10 anxiety" and now know what they need to do to get ready. There is plenty more to do, and more information is forthcoming, but the first steps have been laid out.

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.

Evan M. Gwilliam, DC, MBA, BS, CPC, CCPC, CCCPC, NCICS, CPC-I MCS-P, CPMA, executive vice president of ChiroCode and Find-A-Code LLC, graduated from Palmer College of Chiropractic as valedictorian and is a certified professional coding instructor, medical compliance specialist, and professional medical auditor, among other things. He provides expert witness reports, medical record audits, consulting, and online courses for healthcare providers. He also writes books and articles for trade journals and is a sought-after seminar speaker. He has a bachelor’s degree in accounting and a master’s of business administration, and he is one of the few clinicians who is a certified ICD-10 Instructor and certified MACRA/MIPS healthcare professional.