Do You Hear What I Hear?
Written by Holly Louie, RN, CHBME, PCS | Wednesday, 26 November 2014
As I reflect on the many comments from physicians, coders, educators, auditors, and various organizations, a message of frustration keeps creeping into the conversation. Physicians aren’t cooperating. Physicians don’t want to hear about ICD-10. I can’t get my doctors interested. As I reflect on the reasons that might exist for this perception of frustration, I thought actually investigating the message might shed light on the topic. Although the findings are not statistically valid, I believe they provide perspectives that can prove valuable as we move toward the finish line on ICD-10 implementation.
Why? Such a basic question that has so many paths to trouble! We all know the whys: ICD-9 is obsolete, codes don’t reflect current practice, it does not provide the granularity needed, and the list goes on. So much information that does not answer the most basic question!
For many physicians, they honestly believe they are doing just fine with the obsolete code set; it is a known system that has worked for all of them for their entire careers.
They rely upon a small subset of codes in their practices, so some of the most robust ICD-10 differences may not seem relevant to them. They can document what they need to know and communicate to another medical professional. They read and interpret information from other professionals with no difficulty. They can talk to the patient, and the patient is not complaining. They have zero concerns about the quality of care they are delivering. They don’t look at or see ICD-9 codes in the medical records they use and they don’t send ICD-9 codes to their peers. To have any credibility, we must answer the why question in a way that makes sense to them. “Because we said so” is not the answer. Neither is the usual mantra that they can’t relate to in any meaningful way.
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