Physicians have to deal with a 100 paper cuts each day. Implied threat of lawsuits, RAC audits, denied claims for reimbursement, EMRs designed by computer scientists who do not practice medicine, and more. While these distractions are time consuming, stress-provoking, and aggravating, they are generally manageable. That’s why I was surprised to hear from an ENT surgeon who said that ICD-10 will be the game changer, choking cash-flow. Here’s what he said.


ICD-10 requires an all hands on deck commitment to learn and implement. There will be tens of thousands of codes to enable “more accurate” documentation. Whereas before you could just document a simple description of diagnosis – you will soon need to include deep details. A laceration will no longer just be a laceration. It will include laterality, depth, length, and cause. Seems easy enough. But, given the unlimited panoply of choices, it will be anything but simple. And, don’t assume just because you were a good boy or girl and coded the diagnosis properly, it qualifies for reimbursement. That diagnosis might be excluded from payment. Or “improper coding” might be a convenient excuse to delay reimbursement.


And there’s the rub.


When the next paper cut chokes off cash flow, the life blood of a practice is drained.  No cash means you cannot pay for rent, your employees, your vendors, and so on.


ICD-10 implementation has been delayed for the foreseeable future. A strong argument can be made that the cost far outweighs any perceived benefit. While rallying around the Kill-ICD10-Flagpole has limited sex appeal as an emotionally-charged issue, ICD10 might be the single most important issue separating success and bankruptcy for small practices in the future. Who knew?