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Most dermatologists know that starting October 1, 2015, the 10th revision of the International Statistical Classifications of Diseases (ICD) will take effect. Although recently delayed by one year, the transition to ICD-10 is still imminent. With the postponement, it’s tempting to put off planning for the switch even longer. Instead, physicians should move forward with ICD-10 readiness and use the added time to train and test new systems and procedures they plan to implement. If physicians do not properly prepare for this change, they could experience significant impacts on their practices in regards to both time and money.


ICD-9 codes have been in place for 35 years, so the system could certainly use a refresh. These changes are meant to create more accurate payments, fewer rejected claims, and payfor- performance in medicine, all of which require much more specific coding. As a result, ICD-10 brings with it approximately 141,000 codes in contrast to the current 13,000 ICD-9 codes. These codes are alphanumeric with three to seven digits, as opposed to the mostly numeric, three to five digit ICD-9 codes.


While ICD-10 may have several benefits for physicians, it is understandable why dermatologists may feel overwhelmed with the adjustment. The stakes are high, since physicians who do not have the systems in place to work with the codes properly may lose out on payments they deserve. Moreover, they could lose precious time sorting through the nearly 141,000 codes to find the few they need for every patient visit. And if physicians must spend an additional several minutes during each patient visit to ensure patient information is recorded accurately, this means potentially decreasing the number of patients seen every day—ultimately resulting in lost revenue for the practice—or working longer hours.


Of course, technologies like electronic medical record (EMR) systems have been developed to help take on the responsibility of searching through codes to free physicians from wasting time tackling this manually. Even so, efficiency and accuracy will remain a problem for physicians if they are not equipped with the proper technology to deal with the switch to ICD-10. Although most technologies come with general equivalence mapping (GEM) to translate ICD-9 codes to ICD-10 codes or at least a system of looking up the matching ICD-10 code, these are only so useful due to the drastically greater number of ICD-10 codes available. Even more, only five percent of ICD- 10 codes completely match ICD-9 codes, so translation tools and searching methods will only be so helpful, and may even serve to further complicate the issue.


To most successfully navigate the transition from ICD-9 to ICD-10, physicians must pick a system that does more than attempt to match codes correctly. Physicians need a system pre-programmed with ICD-10 codes so they need not rely upon a middle-man, in a sense, to translate codes to determine which are necessary for each patient encounter. If a product relies upon mapping or translation tools, it is likely not prepared for ICD-10. Just as ICD decided the entire coding system needed a refresh, the technology responsible for interacting with those codes needs a refresh as well, which means dermatologists should look for products with integrated ICD-10 coding built upon proven algorithms.

By obtaining a system that is ready for ICD-10 and properly training the entire practice to use it, dermatologists have nothing to fear when October 1, 2015 rolls around. Making these preparations will allow physicians to not only maintain but also improve accurate and efficient workflows. Now is the time to ask if your practice is ready for the coming changes, and ,if not, take the steps to ensure it will be.

Michael Sherling, MD, MBA is the co-founder and Chief Medical Officer of Modernizing Medicine in Boca Raton, FL.

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