Weighty Issues

The changeover to ICD-10 presents a number of burdens

Are the clinicians in Shannon’s practice ready for the new documentation requirements that go with ICD-10?

Mike strolled into the physical therapy practice. It always made him feel energized just to walk in — the bright colors and happy faces gave the room a sense of energy, and even when it was quiet, he felt as though upbeat music might start at any moment.

Not today. Mike saw his wife talking with Tana, one of the trainers, and stopped in his tracks.

Tana’s arms were crossed. Her head was pointed down and her lips were tight. She was balanced on both feet but leaning back; Tom felt that she looked ready to protect herself.

Shannon seemed calm, but somehow the more Tana leaned back, the more Shannon seemed to move in. Shannon was gesturing, but it didn’t look as though she was angry.

“Hey!” Mike called out cheerfully. Maybe I can break the spell, he thought.

“Hi, honey. Have you met Tana? My husband, Mike.”

Tana shook hands and smiled, but she still seemed troubled to Mike.

“Nice to meet you, Mike. And Shannon — thanks for letting me know.”

“Sure thing,” said Shannon. “Don’t worry, okay? We’ll work it out!”

Mike thought that Shannon’s usual cheerfulness seemed a little strained, too. He walked with her to her office in silence.

“So? Anything you want to talk about?”

Shannon sighed. “Were you coming to take me to lunch, by any chance?”

“I was coming to let you know that I’ve caught an extra shift tonight; Saul’s getting married tomorrow, so for some reason he wants the evening off. I’m going to cover for him at the dinner service and I probably won’t be home till late. If you’ve got the time, I’d be happy to keep you company over lunch.”

“I’m going to make the time,” Shannon said, shrugging into a jacket. She was silent again as they crossed the room, waving and smiling as she went, and her smile disappeared once they left the building.

“So what’s up?” Mike asked, putting an arm around his wife as they strolled down the street, heading for a favorite sandwich shop.

“Do you remember the day I came home and told you how everybody had gotten so upset at the meeting about the new software?”

“I do. I remember you felt blindsided.”

“I sure did. And my talk with Tana was like that, too.” Shannon turned into the shop and joined the line of hungry customers. “You know we’re working on making some big changes with the insurance reporting codes.”

“ICD-10 versus ICD-9. It’s engraved on my heart,” Mike joked.

“I know what you mean!” Shannon laughed back. “Anyway, we’ve been working on getting our office systems up to speed for the change in October, and I’ve reached the point where I talk with the clinicians about their approaches to documentation.”

“I remember you said the changes in the codes would affect everything, not just the billing systems.” Mike reached the front of the line and ordered. Shannon grabbed a couple of bottles of water and they headed to a table.

“It’s going to be good in some ways,” she said, picking up the thread of their conversation again, “but it’s important for us to get it right. Just one small example — we have to specify which side of the body we’re working with now.”

“That doesn’t sound like something to be upset about.”

“I know! But somehow as we discussed how specific the new documentation needs to be, it seemed as though Tana felt like I was criticizing her. Worse than that, I thought she was going to cry.”

“Her body language looked very defensive,” Mike agreed. “You don’t have any idea where that’s coming from?”

Shannon shook her head.

“Maybe,” Mike said, raising one eyebrow, “there’s a childhood trauma involved.”

Shannon rolled her eyes. “I don’t know, but I know that we all have to get on board with the new requirements for documentation, or we’re going to be doing a lot of work for free.”

Are the clinicians in Shannon’s practice ready for the new documentation requirements that go with ICD-10?

Want to know how to prepare your practice for ICD-10 coding?