Did any of you catch the ICD-10 TweetChat Kareo hosted on Tuesday?  I participated representing our team(@capkoandcompany); three other panelists from different segments of the medical management world joined in as well (@brad_justus, @modmed_EMA, @hitconsultant).  Kareo does a wonderful job reaching out to its clients and the entire practice management community with events like these — and we were delighted to have the opportunity to participate!  (Kareo published a summary on its blog — and you can also search all the tweets using #kareochat .)

As expected, there were many smart, informed comments — and some really good questions by the Kareo folks in particular.  But, I was struck by the relative silence from people who weren’t from the billing/practice management/technology expert community (i.e., from actual billers, coders and practice managers) — especially because one of the themes that emerged from our chat was the sense that small and medium private practices (in particular) have been holding off dealing with ICD-10.  Did the audience that could benefit the most shy away from the chat altogether?

The drumbeat of journalists, bloggers and other experts about the need to deal with ICD-10 NOW (or face likely disaster!!) has gotten louder and louder in recent months, and I sometimes wonder if it sometimes has some negative unintended consequences. In our zest to create helpful urgency (and dispel the dream that ICD-10 will be delayed again), are we pushing people towards fear-induced denial and procrastination?

Seemingly every week, we work with medical practices that have not begun to prepare for ICD-10 at all — and they’re scared.  But while their foot-dragging has not been ideal by any means, it’s also not a guarantee of disaster.   Converting to ICD-10 is not going to be easy, but it’s also not something that’s beyond the reach of any practice to manage — especially because so much help will be available from vendors and payers (provided you ask!).

It seems from our vantage point that too many practice administrators, billers and coders have already decided — without even really getting started — that ICD-1o will be an unavoidable nightmare (so why bother rushing around to prevent it?).  Not only is this not the case, there is still more than enough time for most small and medium practices to pull together their plan, begin educating themselves, and start working with their key partners to ensure a manageable transition.  The key is to START — when you do, you’ll have a better perspective on the reasons behind ICD-10 (and even some potential benefits for practices), the impact on your specialty (some providers will have it a lot easier than others), tools to educate your providers (your specialty society and publications targeted to your specialty are great places to start), ways to protect your practice (lines of credit and cash reserves, especially) and the best ways to coordinate with your payers and EHR/PM vendors (who frequently have lots of information available to help).

ICD-10 is a case where fear of the unknown is worse than the unknown itself — because fear that causes delayed action makes the unknown much worse and more stressful than it needs to be.

As I said in the chat, ICD-10 is like that old joke about how a man eats an elephant — one bite at a time.  Take a nibble, right now, while you’re thinking about it.  Start with reviewing the codes for your own specialty, or with information offered by your PMS or EMR vendor.  Commit to a little learning at a time over the next few weeks, and you’ll be ready to take control of planning and testing — and to keeping your practice on track during the upcoming transition.


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