The 5 Major ICD-10 Obstacles for Chiropractors (& How to Overcome Them)


Chiropractors officially have one year to prepare their practices for the launch of ICD-10 in October 1, 2015.

While your inner procrastinator may try to persuade you that that this is a long way away, there are five significant obstacles standing in your way that should motivate you to start preparing as soon as possible.

The 5 Major Obstacles ICD-10 Will Produce

1. Clinical Challenges. The ICD-10 Codeset is Bigger in Scope Than You Realize – one thing has become immediately apparent to anyone who has actually taken the time to map out the transition from ICD-9 to ICD-10 codes: the scope is MUCH bigger. For example, ICD-10 is not a simple matter of plugging in your old familiar ICD-9 code and getting a new one. Because the new codeset has exponentially expanded, a single ICD-9 code can literally turn into a handful or even dozens of ICD-10 codes, which massive specificity and variations on what was formerly a single theme.

2. Administrative Challenges: This expanded scope will not only cause confusion, it will create a series of administrative challenges. For example, if you are like many chiropractors who currently use a Fee Slip in your office that includes your CPT codes, charges and diagnosis codes, you will immediately run into a very big problem. Unless you can read 6 point font, there’s no way you will get your most commonly used Dx codes to fit on that form due to the fact that there are so many ICD-10 variations!

3. Documentation Challenges: One area that the media has ignored in the wealth of information published about ICD-10 is the effect the new codeset will have on “adjacent” areas of our chiropractic practices. While it is true that ICD-10 alters only the diagnosis codes (CPT codes remain the same for chiropractors), your dx codes won’t be the only thing to change. Your documentation, for example, will need to undergo an overhaul to reflect the specificity of ICD-10 codes. In some expert opinions, the single biggest challenge for ICD-10 will not come from coding but from accurately documenting your services to match the new codes. Fortunately, you can begin to practice this without even using the new codes if you begin preparing now and making the necessary changes now towards ICD-10 specificity. That way, when the time to implement the new codes comes, you will have already been used to your “new” documentation style. This will be a big hurdle for many DC’s who admittedly need to improve their current levels of documentation. Unfortunately, if they don’t “step it up” for ICD-10, it will be even easier for a payer to issue a denial for your services.

4. Usage Challenges: Perhaps the most widespread challenge ICD-10 will create is the simple “use” of the new codeset. Face it – like it or not, we are all familiar with how ICD-9 works and we take for granted the various rules of ICD-9 coding because we have utilized its framework so many times. With ICD-10, we have no such familiarity. Therefore, every mistake we make will cause delays, denials and dollars lost. Fortunately, some payers are allowing you to test submit ICD-10 claims prior to the October date. Unfortunately, not all of them offer this. And in order to even do that, you have to be familiar with using the ICD-10 codeset. As far as I can tell there is only way to gain familiarity and overcome this usage challenge: at the risk of being incredibly obvious the answer is to actually use it! Again, that means you have to start sometime, preferably before October 2015 ☺

5. Financial Challenges: Across the various healthcare disciplines, there is much anxiety in regards to the potential financial damage that ICD-10 will inflict – especially on small physician practices (like ours). Let’s face it — no one believes ICD-10 will be a seamless transition. Because of this, most experts are recommending that you create a cash reserve to help you prepare for the inevitable problems. For smaller entities like chiropractic offices, 3 months cash may be necessary; most larger groups and hospitals are attempting to tuck away much more than that.

How to Overcome These ICD-10 Challenges

Fortunately you do have options to prepare. Here are my three best recommendations:

1. Start Online Training with Your Staff. By beginning your training now, you will have ample time to thoroughly understand the changes and the requirements and formulate a plan for your office that allows you enough time to get ready. Our ICD-10 Implementation Training For Chiropractors and Their Staff online course is designed to help you do exactly that. (and if you act quickly, you can save big before prices increase in 2015)

2. Prepare Your Administrative Needs: make sure your EMR company has you ready and/or get your fee slips and diagnosis code lists assembled. Our ICD-10 Reference Sheets are a perfect resource for this purpose.

3. Attend a Live Workshop – when the date gets a little closer (in 2015), finalize your preparations by attending a live workshop where you and your team can learn some additional tips and iron out the wrinkles before you go live.

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