Mental health practice faces an uphill battle
What is Alex facing with the change to ICD-10 codes?
“Good morning, Luisa,” Alex Friedman said. “How does the day look?”
“Your first client is a no-show,” Luisa informed Alex. “But that’s a good thing.”
Alex raised an eyebrow.
“It’s good because I’ve been getting my head around the ICD-10 reporting changes,” Luisa went on, “and we need some time to strategize. Pull up a chair.”
Alex took a seat, a little hesitantly, but willing to hear her out. “The AMA’s American Medical News reports that the medical practice management association estimates that a practice like ours will spend $83,000 getting ready for the changes that are coming on October 1st.”
“You have my attention,” said Alex. “I think I might need a cup of coffee to get through this, though.”
“I’ll get your coffee and you can do whatever else you need to get ready for this conversation,” Luisa offered, “but I think you’re going to want to hear what I have to say.”
Alex was fairly sure that he didn’t want to hear it, but he knew he needed to. Some of his colleagues had shared that they had been working on the transition to ICD-10 codes for over a year, and he was just beginning to think about the transition. He put his briefcase in his office, grabbed the coffee Luisa offered him, and settled in to listen.
“First,” she said, “it’s going to be expensive. Upgrades to the software, disruptions in the workflow, new systems to learn — you know those things always cost in productivity as well as the obvious costs.”
“Second,” Luisa went on, “we’re looking at a steep learning curve. I know we’ve been talking about looking at new billing systems anyway–”
“It’s time,” Alex said. “We’ve got to get our office systems into the 21st century sometime.”
The phone shrilled. Alex watched as Luisa handled the call, and another that came in as soon as she hung up from the first. He was impressed anew by the speed with which she could find the answers to questions. That would change when they changed all their systems, he thought.
“The new ICD-10 book has over 1100 pages,” Luisa continued when she finished the calls. “The old codes don’t map to the new ones in a simple way. We’re not talking about updating a spreadsheet.”
Alex nodded. “It sounds as though this is not just a lot of work, but also open up the potential for errors. We could be looking at a lot more nonpayment of claims as we get used to it, and maybe even at audits.”
“You’re right.” Luisa sipped her own coffee. “Payers will be struggling with the changes themselves, but their goal naturally is to keep their costs in check. There’s a lot of room for interpretation. I already sometimes feel like we’re not on the same side, and these changes could really affect our cash flow.”
The phone rang again.
Alex surveyed the rows of paper files as Luisa dealt with the call. “This is going to affect case notes, scheduling, billing… everything, really,” he said when she finished. “Can we implement the changes gradually and work our way in?”
Luisa shook her head. “No. Sorry to put it so baldly, but basically we have to use ICD-9 codes until the last day of September and ICD-10 codes on the first day of October.”
“I get that you’re going to need support from me, Luisa, but I don’t have an unlimited budget, and I can’t afford a disruption in the practice. Our clients rely on us.”
“On that note,” said Luisa, who had picked up the phone again, “I think you’re going to have to take this call.”