ICD-10: What it means for radiologists

While radiologists are likely to be shielded from much of the pain associated with the transition to ICD-10, it remains important to keep pace with such efforts, according to Melody Mulaik, a coding and billing specialist who spoke at last week's American Healthcare Radiology Administrators fall conference in Baltimore.

Mulaik, president and co-founder of Powder Springs, Ga.-based Coding Strategies, said that one area where radiologists will need to be especially alert will be clinical data reporting.

"Think about the quality of the clinical data you receive [from referring physicians]," Mulaik said. "How many of you always have referring physicians give you all the details you need? That's going to get worse in ICD-10."

Mulaik said that radiologists should expect increased harassment from health information managers for better quality data. To that end, she said, radiologists themselves are going to have to do more dictation in ICD-10.

"For instance, think about the number of unspecified codes we use in radiology," Mulaik said. "Eventually, the payers are going to say, 'How do you not know X, Y or Z?' Think of the message an unspecified code sends--'We don't know where the cancer is, but we're going to treat it with radiation anyway.'"

Despite several medical associations indicating that their physicians are struggling with the transition to ICD-10, Mulaik urged radiologists to not be distracted by the noise around them.

"We are implementing ICD-10 on Oct. 1, 2014. Would I be comfortable better on that date? I would," Mulaik said. "[The Centers for Medicare & Medicaid Services], when they pushed it off a year, technically didn't have the authority to do that, but they did it anyway. Congress said, 'you went beyond your authority, but we're going to let it slide, and you can't push it off again.'"

An June analysis by the American Health Information Management Association painted a bleak picture for hospital ICD-10 implementation efforts, stating that most facilities either had not started with the transition, or were still in the very early stages. What's more, a survey published in April by healthcare revenue IT vendor Health Revenue Assurance Holdings found that 20 percent of responding small- and mid-sized hospitals had yet to start any education or training for the shift.

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