November 6, 2015 Owen Carey

Teaching an Independent Physician Practice New ICD-10 Tricks

ICD-10 implementation is one month old. How are independent physician practices faring?

To help provide a snapshot of sorts regarding an answer to this question, recently chatted with Michael Creef, MD, a Virginia-based independent family physician focused on enhancing physicians’ overall ICD-10 knowledge base and Electronic Health Record (EHR) proficiency.

independent physician practices ICD-10 implementation Electronic Health Records

With nearly half of independent physicians turning to retirement as a viable post-ICD-10 option, Creef says he has managed to stay independent even through numerous bouts of Affordable Care Act legislative snafu and is indeed still standing after the ICD-10 transition.

You can teach an old dog new EHR tricks

Having run a practice both within the pre and post eras of the Affordable Care Act (ACA), Creef says he has successfully implemented EHRs into his independent practice only after initial reluctance.

“Last October, we were not into electronic records,” says Creef. “This changed when it appeared ICD-10 was not only on the horizon but the horizon had arrived.”

Making the EHR move took time, says Creef. Throughout the learning process, patients were generally understanding about filling out more paperwork, he says.

“I picked EHR use up very quickly, was pleased with it, and was able to impart it to my colleagues. Consequently, this has decreased the amount of time a patient was spending on paperwork and helped us to be able to get things rolling on a much faster basis,” states Creef.

“Years ago, I said I wasn’t interested in electronic records. Now I’m not only interested in it, I’m teaching them, and I like it,” Creef maintains. “You can teach old dogs new tricks, believe me. The oldest member of our group is 83 and even he’s come around to it.”

ICD-10 is about embracing specification

ICD-10 is about specificity, says Creef. Shortcuts for the sake of time are not the long-term answer, he adds. Creef says dealing with specificity and a seemingly infinite number of choices to choose from proves challenging but is needed.

“We have to get specific with our thinking. When doctors in an emergency room pick up records, they’ve got to know where your train of thought was,” Creef says. “Your codes have got to be so specific that they support your records and therefore are your diagnosis based on what you’ve signed when you see that patient and when you make your differential diagnosis.”

Out with the ICD-9 old, in with the ICD-10 new

Can an old dog learn new tricks? Creef says ICD-10 implementation has not been generally well received by the greater healthcare industry because it is new. However, there is no choice but to adapt and progress onwards, he says.

Although ICD-10 essentially determines whether or not physicians are paid, Creef says many physicians are not taking it as seriously as they should, subsequently upping their risk of audit.

“I’m hearing in the community some physicians are saying they’re not going to enforce this as heavily as they say they are. You’ve got to get across to them that yes they are,” says Creef.

“Things have changed. Physicians and other healthcare providers need to understand that they have to get on board with this, like it or not.”

Creef says he has seen general acceptance and patience thus far with those around him working to make the ICD-10 transition as seamless as possible.

“Our staff and patients have been more than willing to work with us in the new advent of ICD-10,” says Creef. “They understand exactly what we’ve been going through because we’ve been quite honest with them to let them know about the new coding.”

“The billing company we have is very good at catching whether or not a code is specific enough. Our doctors are very good about putting in code laterality and specificity,” says Creef.

“We had a lot of input from a billing company who is good friends of the doctors in the practice. They came in early and started with the education and then I came onboard to help with the teaching of the EHR,” Creef explains. “We offset a lot of problems that really could have been horrendous to say the least.”

This article originally appeared here.

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