• Dr. Gautam Kedia, MD of Lifetime Heart & Vascular, thoughts on ICD -10

  • Last month’s article featured the topic of ICD-10.  I was fortunate to interview Jennifer Job, COO, Sun Valley Medical Billing Company, on her thoughts regarding the impending change from ICD-9 to ICD-10.  Jennifer shared her insights and perspective regarding the implementation of ICD-10 and the impact it could have on the billing companies, medical providers and the medical industry as a whole.

    With a little over 30 days until October 1st, the target date for implementation of ICD-10, I invited Dr. Gautam Kedia, MD, Lifetime Heart & Vascular, to share his thoughts on ICD-10 and his organizations ICD-10 readiness. 

    Judith: Do you think that there will be any last minute delays of ICD-10?

    Dr. Kedia: I don’t think it will be delayed, though I am sure most medical offices are hoping. There has been some talk of even skipping ICD-10 and moving directly to ICD-11 which Europe is apparently already moving towards.

    Judith: How long has your staff been preparing? Would you say they are prepared?

    Dr. Kedia: Our staff has been preparing for the last 6 weeks, they are not yet fully prepared.

    Judith: Do you feel with the changes in the number of codes increasing to 68,000, this will have a huge impact on your specialty practice? Or will the larger impact be felt at the Primary or Urgent Care level?

    Dr. Kedia: I think they will affect all of us. The increased codes will affect Primary Care more because they have to deal with many more diagnoses than specialists. For most of us, it will have the greatest impact in the first three months since there are rumors that insurance companies will delay sending payments, there will be lots of confusions, etc. There may be difficulty for some offices to keep up with their account receivables. Also in the first month as we are learning the new codes, it will slow down our workflow. Plus it’s happening at the start of winter, typically when things get busier for practices since patients become ill in the cold weather times.

    Judith: Have you analyzed your account receivables to see what the impact could be if you were not paid from the insurance reimbursements for 90 days? Have you obtained other resources to handle any cash flow short falls?

    Dr. Kedia: Yes, we have. We are saving towards that end. It’s also good to have a line of credit in place.

    Judith: Have you contacted your payors, as the Centers of Medicaid and Medicare Services (CMS) has suggested, to see if they are prepared for the switch to ICD-10?

    Dr. Kedia: Yes, most payors are saying they are prepared, though not all of them are ready to accept “test claims” yet. Regardless, most of us are expecting and preparing for confusion and delays for the first few months.

    In an announcement earlier last month, the CMS stated that they won't be rejecting claims for payment simply because the ICD-10 code submitted isn't specific enough. This is a significant concession to organized medicine, giving them a 1-year grace period for claims bearing the ICD-10 diagnostic codes that go into effect October 1st.

    Judith Lindsay, owner of JAL Consulting & Associates tackles all the elements of the HIPAA compliance puzzle, successfully assisting organizations to make sense of it all.  Judith uses a holistic approach by providing guidance on which policies, procedures and processes are needed for any size or complex organization. Judith's blogs can be found weekly at her Linkinedin account and is available for speaking engagements related to the world of compliance.  Connect on Twitter or Linkedin.  

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