The ICD-10 Files

This isn’t going to be a friendly, glossy, keep-your-chin-up kind of ICD-10 post. Like the high school teacher who saw your potential and demanded you achieve it, I’m here today with a little tough love. For the past three years, my team and I have talked until we were blue in the face about preparing for ICD-10. We didn’t do this because we love writing about ICD-10 (though we do have some fun with the topic), but rather because we understand just how dramatically it will change the way rehab therapists—and healthcare professionals in general—do business, and we want you to understand that, too.

Deny Everything

All too often, though, our words have fallen upon deaf ears. Instead of spending their precious time preparing for the switch to ICD-10, many providers began to pitch a fit over the transition, stirring up a lot of controversy, conspiracy theories, and misconceptions. Worse yet, some tried to pretend it wasn’t real—or did not, in fact, know it was real. And the closer we come to the October 1 transition date, the more providers seem to resist. To show you what I mean, check out some of the social media responses to WebPT’s ICD-10-related blog posts we’ve received over the last few months:

  • “Stop fear-mongering.”
  • “ICD-10 will never happen.”
  • “Yuck!”
  • “Ugh.”
  • “I don’t think I’m going to like this.”
  • “All those codes I knew off the top of my head for YEARS are going to be gone. Forget ICD-10.”
  • “Unfreakingbelievable.”
  • “Sh@$&.”
  • “Good luck. I’m done with coding.”
  • “Stop the paranoia.”
  • “Noooooo.”
  • “We older folks don’t like change.”
  • “Still hoping AMA will stop it!”
  • “WOW. What a nightmare this is going to be.”
  • “Not a fan.”
  • “Don’t remind me.”
  • “What is this?”

(My personal favorite was a picture of Robert Downey, Jr., as Tony Stark, rolling his eyes.)

Well, dear readers, let me be the Mulder to your Scully: While I can’t comment on the existence of aliens, I can tell you ICD-10 is real—as are the consequences of not adequately preparing for the switch—and quite frankly, complaining about it isn’t going to change a darn thing.

It’s Not Coming—It’s Here

ICD-10 certainly didn’t bum-rush the healthcare industry. In fact, we’ve seen it coming for decades. Now, despite seemingly endless delays, we’re about to witness a long-overdue change in the healthcare industry. It’s no longer a question of whether the transition to ICD-10 is happening, but whether your practice will be ready for that transition.

Yet, so few providers seem to have accepted the new code set—a fact I can’t quite grasp.

Fear of change is no excuse for resisting it, and ignorance can’t spare you the consequences of failing to prepare. The crux of the matter is that, unless you plan to retire on October 1, 2015, you’re not getting out of this one. (Even if you run a cash-pay clinic, you still need to be comfortable using ICD-10.) By behaving like the ostrich who buries its head in the sand when it senses danger, you’re putting your practice at risk for claim denials, severely reduced productivity, or worse.

The Truth is Out There

President James Madison once wrote, “Knowledge will forever govern ignorance; and a people who mean to be their own governors must arm themselves with the power which knowledge gives.” While Madison was referring to our public education system in 1822, the heart of his message applies to our current situation.

Here’s how I see it: the way we as rehab therapists approach ICD-10 will dictate our entire future. This transition to ICD-10 is a fork in the road; you can choose either to take control—or allow yourselves to be controlled.

ICD-10 isn’t just a new code set. It’s a call-to-action for a profession that desperately needs a cohesive, powerful voice. But the voice I’ve challenged rehab therapists to develop is not one that ignores or complains about forward progress, but one that demands and sparks innovative change. ICD-10 is most certainly a big change, and no doubt there will be some growing pains as an entire industry adjusts to a new way of coding—and critical thinking—but that doesn’t mean we should be scared of it. In fact, we should be excited about it.

Rehab therapists deserve a more prominent place in the patient’s clinical pathway, but at the moment, we just don’t have enough evidence to unequivocally prove our value. ICD-10, as a data source, can change that. Because the updated code set is far more specific than ICD-9, the resulting data can paint a clearer picture of the complexity of the patients we see every day. Thus, this transition will give payers greater insight into the types of patients we treat and the outcomes we achieve, thus shedding light on utilization rates and potentially justifying higher payment rates.

The truth, then, is this: ICD-10 is an opportunity, not an obstacle.

Now, more than ever, we have the chance to stake our claim on the healthcare landscape. In the dawn of direct access, rehab therapy is having a moment. By empowering practitioners to demonstrate the value of our services, ICD-10 can help rehab therapists extend that moment. If you choose not to capitalize on that out of fear and ignorance, you can only blame yourself.

 

I’ve always urged for us to own our roles as healthcare professionals, and in doing so, take charge of our destiny. But the choice is yours: roll up your sleeves and embrace the change, or dig in your heels—and in doing so, likely dig your clinic’s grave.

Harsh? Perhaps—but words hurt a lot less than having to close your doors.

About the Author

Heidi Jannenga, PT, DPT, ATC/L, Founder and COO of WebPT

As Chief Operating Officer, Heidi leads the product strategy and oversees the WebPT brand vision. She co-founded WebPT after recognizing the need for a more sophisticated industry-specific EMR platform and has guided the company through exponential growth, while garnering national recognition. Heidi brings with her more than 15 years of experience as a physical therapist and multi-clinic site director as well as a passion for healthcare innovation, entrepreneurship, and leadership.

An active member of the sports and private practice sections of the APTA, Heidi advocates for independent small businesses, speaks as a subject matter expert at industry conferences and events, and participates in local and national technology, entrepreneurship, and women-in-leadership seminars. Heidi is a mentor to physical therapy students and local entrepreneurs and leverages her platform to promote the importance of diversity, company culture, and overall business acumen for private practice physical therapy clinics.

Heidi was a collegiate basketball player at the University of California, Davis, and remains a life-long fan of the Aggies. She graduated with a BS in Biological Sciences and Exercise Physiology, went on to earn her MPT at the Institute of Physical Therapy in St. Augustine, Florida, and obtained her DPT through EIM in 2014. When she’s not enjoying time with her daughter Ava, Heidi is perfecting her Spanish, practicing yoga, or hiking one of her favorite Phoenix trails.

4 responses to “The ICD-10 Files

  1. Heidi-
    Thanks for writing this post. I agree with everything you said. While I use a different EMR system than WebPT, at our California Annual Conference this past weekend, the payment policy team gave a great talk about it. Then after talking with our practice affairs coordinator, it really hit home that this is the opportunity for PT’s to really have a conversation (albeit numerically based) as to what’s going on with our patients and why we are treating them. I see this as yet another step going forward for the profession. We need to embrace it and accept the challenge with both hands. Thanks again.
    Leigh

    1. Thanks for the comment Leigh. it’s great to hear that the conversation re: the importance of data on physical therapy is starting to happen and sinking in to more and more therapists. Plus, as this Examiner article explains, “…the ICD-9 coding system was never intended to be used for documentation of diagnoses in a patient’s medical record. It was a statistical system for public health that was adopted by insurance companies for payment purposes.” It’s time to move forward. We have been playing defense without any strong weapons. Data driven decision making is key for us as PTs to really find our voice and show our value.

  2. Thanks for sharing the valuable post. Yes I agree, ICD-10 is an opportunity. Using ICD-10 effectively will help get us to real value and evidence based medicine faster. ICD-10 and EHR’s, if used properly, will give physicians their own database of information with which to justify what they have always known but could not demonstrate.

    1. You are very welcome. Glad you found it helpful. Appreciate the read and hope you stay tuned as there is much valuable info here and at webpt.com/blog

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