ICD-10 Solution for Orthopaedic Surgeons

While reviewing the impact and “game plan” for ICD-10 implementation for our various clients, we found this article – published in 2013 – from the American Academy of Orthopaedic Surgeons: “Are You Ready for ICD-10? The deadline is less than 1 year away”. Well, we all now know that October 1, 2014 has come to pass and we are still using ICD-9 codes. HOWEVER, HHS and CMS have issued a final rule that finalized the new deadline for October 1, 2015. While we would never be so foolish as to consider this a “definite” deadline, most stakeholders in the industry are expressing confidence that this new date *actually* will be the honored deadline.

Thus, the AAOS article’s title bears relevancy today: “The deadline is less than 1 year away!” Come next year, orthopedic practices will especially feel the burden of the change, as new specificity rules will require the traditional orthopedic diagnoses (and documentation!) to be far more detailed. The new diagnosis set will introduce or heighten the existing requirements surrounding combination codes, laterality, episodes of care, exact anatomic location, clinical details, and etiology/cause. As examples, the new code set will require orthopedists to specify the precise regions of a spinal ailment, specify whether a patient’s osteoarthritis is age-related, localized, fracture-related, drug-induced, etc.; laterality will need to be selected for nearly all of the diagnoses; fracture care will need to be coded to reflect the type of encounter (initial, subsequent); and external injuries will need to include detail on the place of occurrence. These broad strokes of the change serve only as umbrellas covering the thousands of new codes that orthopedic surgeons will be expected to use on October 1, 2015.

While some orthopedic providers may consider hiring professional coders, or rely upon their existing EHR systems to see them through the change, we know that there are also plenty of providers and practices that aren’t interested in taking on more office staff OR investing in an EHR system that may – or may not – make this transition easier. For these physicians and practices, we have a viable solution: an electronic superbill that will mirror the orthopedic provider’s existing paper superbill. The beauty of the electronic superbill is that the physician will be able to select the traditional ICD-9 code that she or he is familiar with, and the superbill will then “drill down” to reveal the appropriate ICD-10 options from which the physician can select. We have partnered with White Plume Technologies to bring our billing clients this solution. Want more information? Check out this ICD-10 video for a quick demo, or CONTACT US  TODAY.