Recently, I received an e-mail newsletter from Clinical Pain Advisor on a controversial topic, the new ICD-10. It is an essay written by Steven Croft, MD, “Why ICD-10 will do more bad than good.” At the same time, I also got advice from my legal counsel that I should drop ICD-10 because it will do more harm than good for my practice since I do not accept any insurance.
Here are some of the comments from his essay:
ICD stands for “International Classification of Diseases.” Physicians are required to follow the latest guideline for ICD 10th Revision (ICD-10) by October 2015 when they submit to insurance for medical service reimbursement.
Do you care to know what ICD means for you? ICD created international standards for collecting data with the goal of improving the quality of patient care. It was also intended to be used for reimbursement by justifying “medical necessity” and improve upon detecting fraudulent activities.
For practicing physicians, ICD codes are used for one reason alone: to file claims and get paid. The United States is the only country using ICD codes to pay physicians. The number of ICD codes will increase from 13,000 to over 70,000 that serve no real purpose. For example, migraine headache alone is designated by 64 separate codes. This incredible increase of codes only adds confusion, demands more time from physicians, who are already under time pressure, and results in more claim denials.
ICD-10 adds nothing to patient care. This is driven by the health care informatics industry and is embraced by administrators monitoring numbers and statistics to accept or deny insurance claims. They are not the ones taking care of patients. ICD-10 is misleading and self-serving for the health care informatics companies and is not in the best interest of patients or physicians.
If you seek alternative, integrative medicine because major medical institutions could not help you, and your medical problem does not fit within 70,000 ICD-10 codes, your insurance may deny your medical care based on the technicality of “medical necessity.” Insurance companies can also dispute the definition of “medical necessity” for care already provided by physicians and may come back later demanding reimbursement back from physicians or from patients.
Politically speaking, I have to say carefully, dropping ICD-10 codes may or may not save some complicated patients. What you might be hearing is, drop dead ICD-10! I totally agree with Dr. Steven M. Croft’s opinion. Also, based on my legal counsel’s advice, I will no longer provide ICD-10 codes as of October 1, 2015.