The APTA Combined Sections Meeting a few weeks ago was great and Las Vegas is a great city to host it. Everything in Vegas is over the top and larger than life. It seems fitting then that some people were going over the top with their doomsday scenarios about ICD-10 for physical therapy.

You may have heard something like this at the conference, or in other forums out there:

“Start hiring extra staff!”

“You should have enough money saved up to cover 3 to 6 months of operations!”

“The ICD-10 apocalypse is coming!”

“Train, train, train and test, test, test!”

Sure, ICD-10 represents a big change in US healthcare and the physical therapy industry but we don’t need to turn this into a Vegas-style show full of smoke and mirrors.

Let’s wave away the pyrotechnics and get down to reality:

1. Your staff will have to choose a diagnosis code coming from the referring MD, or choose one that applies to the symptoms presented by the patient and it will be different than the old ICD-9 format. (For an explanation of ICD-10 read this blog post)
2. Your billing staff will have to ensure that the right code for the payer is on the claim, meaning they will have to know when a payer starts using ICD-10 instead of ICD-9.

That’s it.

So then why all the talk about how the sky is falling and the doomsday clock is ticking away? Well, if you don’t have a single system for physical therapy EMR and billing that is built to handle constant changes like this, I can imagine how scary ICD-10 sounds. However, hiring an extra person to project manage your readiness and arming them with only a checklist is not a very effective way to tackle this transition.

There’s one thing that is important to be concerned about, though: 

Not all payers will be ready for the switch to ICD-10 on October 1^st. Not only that, not all payers have to make the switch. Therefore, you should think about your payers and your current practice and the systems you have in place, and ask:

1. How will you handle a claim to a primary payer using ICD-10 and a secondary payer using ICD-9?
2. What if your patient’s insurance changes from an ICD-9 payer to an ICD-10 payer, or vice versa?
3. What if a payer makes the switch to ICD-10 after the cut-off date of October 1^st?

If you use a single system for your EMR and billing like Clinicient, those questions are easily answered. Because having a system that knows the payer requirements at the moment the diagnosis code is chosen, means you won’t have to think about it later on. This means:

• If you see a patient for Lumbago, Clinicient will show you the code for both ICD-9 and ICD-10
• Claims will have the right code on them, based on payer expectations for either the ICD-9 or ICD-10 code

Like Functional Limitations Reporting, PQRS, the new CMS-1500 form, and other industry compliance efforts, if you’re using Clinicient, there’s no reason to be scared about the ICD-10 transition for physical therapy.

To learn how to get started with Clinicient , contact us.

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