ICD-10: Are you ready?

Atlanta, GA-ICD-10 is expected to roll out on time for its October 1 deadline, so now is the time to prepare or face the consequences, says Walt West, OD, FAAO, vice president of practice development for Vision Source.

ICD-10’s code sets, complexity, and specificity all differ greatly from ICD-9. ICD-10 will have approximately 68,000 codes just relating to optometry, increased from 13,000 in ICD-9. The codes now offer a full description in modern terminology, and combine diagnosis and its symptoms.

Dr. West says the new codes can be extreme and even overly specific. For example, code W56.01xS means “bitten by dolphin, sequela,” while code W55.03 means “other encounter with a hooved animal.”

“As silly as that is, it demonstrates how specific it needs to be,” says Dr. West. If you have a specific diagnosis, you need more specific data in order to receive payment.

Dr. West said the average optometry practice will lose about $30,000-35,000 during the implementation of ICD-10, mainly due to the decrease in the number of patients doctors will be able to see because they are spending more time on the coding.

In order for your practice to survive past October 1, Dr. West recommends:

• Training for you and every member of your staff

• Budgeting for software upgrades, a reduction in revenue (at least initially), and other expenses

• Revise your forms, contracts, and policies

• Ask your third-party payers and EMR provider if they are thoroughly prepared-if they’re not ready, it means more lost revenue for you

• Consider using outside resources

• Assign someone in your office to attend to the details

• Collaborate with other ODs to test each other for accuracy

• Understand that what works for one practice may not work for yours

• Start getting ready now, if you haven’t already