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Doctor or Accountant?

Stanley B. Cohen, MD  |  Issue: December 2009  |  

TABLE 1: ICD-9 Gout Code Changes for 2010
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New Coding Manual on the Horizon

ICD-10 is around the corner. The United States is slated to move to ICD-10 in 2013. Many other countries have been using ICD-10 for several years and are currently preparing for ICD-11. The United States is behind because of the cost and training issues related to moving to ICD-10. Some reports have listed the cost for a single practice to upgrade to ICD-10 to be as high as $85,000. This is quite a steep price tag to report a diagnosis based on a number. The change from ICD-9 to ICD-10 is going to substantially increase the number of diagnosis codes.

There are proponents and opponents on both sides of the argument to move to ICD-10. I care about how it is going to affect my practice. In my practice, we are currently halfway through the process of moving our entire group to an electronic medical record. Presumably all the software will have to be updated at a cost to our practice. The coding and billing staff will have to be retrained, as will physicians who long ago memorized the 20 or 30 codes that we most commonly bill. It will lead to a disruption in the practice, which will also decrease reimbursement. This is yet another administrative burden to shoulder.

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Why did I become a physician? Certainly not to constantly reinterpret complex coding and documentation rules. Do the patients care what code relates to their diagnosis or procedure? No. This is just another example of excessive administrative work that takes away from the focus of physicians to provide care for their patients. Although the ACR supports reform of the healthcare system, we remain increasingly concerned with the continued increase in the administrative burden in an environment of decreasing reimbursement. The ACR, along with other specialty societies, will continue to fight for our physicians to improve the delivery process and maintain adequate reimbursement so that they can provide the services necessary to ensure quality care. When the dust settles, hopefully the best interests of our patients will be the driving force for change, not the budget.

Dr. Cohen is president of the ACR. Contact him via email at [email protected].

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