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ICD-10 Still Matters for Orthopedic Surgeons

ICD-10 Codes

Here’s Why ICD-10 Still Matters for Orthopedic Surgeons & Why Your EMR System Should be Template-Free

Although ICD-10 was rolled out in October 2015, it is still vitally important to the health of your patients and to the health of your orthopedic practice.

With ICD-10, orthopedic surgeons’ section of codes expanded more than those for any other specialty, and more than eight times the 17,000 codes in ICD-9. This is because orthopedic surgery covers more body regions than any other specialty, which is reflected in the sheer number of codes that have been generated to date.

ICD-9 codes were used for 30 years, so it was certainly time for an update. And, at the time of the ICD-10 transition, the United States was the only industrialized nation that had not implemented the new ICD-10 codes. It is easy to see why many ICD-10 codes exist, considering the vast amount of data as well as the high number of orthopedic advances in medicine that have accumulated over the past three decades. With the increased accuracy of ICD-10 code data, the International Statistical Classifications of Diseases and Related Health Problems (ICD) coding is not just a checkbox on a seemingly endless government compliance “to do” list, but rather a strategic opportunity for managing your orthopedic practice.

Of course, as you already know by now, manually searching for all ICD-10 codes required for each scenario you face is not an efficient way to practice orthopedics. Luckily, there are state-of-the-art orthopedic electronic medical record (EMR) systems available to help relieve the pain of finding the correct ICD-10 codes. Yet even with these aids, you could still find yourself lost in the complexity of accurately coding if your orthopedic software was not designed with built-in ICD-10 coding. Most orthopedic EHR software really miss the mark by using ICD-9 to ICD-10 translators (like Crosswalks with General Equivalence Mappings known as GEMs), which can result in payment denials. Finding exact matches is difficult considering only approximately 5% of ICD-10 codes actually match ICD-9 codes, according to the American Medical Association (AMA).

There is a difference between a standard EMR system for orthopedics that claims to be “ICD-10 ready” using mapping or translation tools versus the best orthopedic EMR systems which utilize structured data that correctly generates ICD-10 codes along with your exam notes while populating them onto the bill. This approach makes you more efficient as you practice medicine and treat your patients – while enabling you to accurately code, bill and receive the payments you deserve.

To fully grasp the complexities involved, a great resource can be found on CMS.com. This helpful guide offers common ICD-10 codes, clinical documentation tips and clinical scenarios. There’s even a maintenance toolkit. Ten of the most common conditions requiring ICD-10 codes include:

  • Cervical Spine Disorders and Displacement
  • Neck and Back Pain
  • Osteoarthritis of the Hip
  • Osteoarthritis of the Knee
  • Radiculopathy (Primary)
  • Rheumatoid Arthritis
  • Selected Shoulder Conditions
  • Spinal Stenosis of the Lumbar Region
  • Selected Sprains – Rotator Cuff, Cruciate Ligament, and Ankle
  • Thoracic, Thoracolumbar, and Lumbosacral Intervertebral Disc Disorders

We connected with one of our clients and orthopedic surgeon for his insights on ICD-10 as well. Daniel Stein, MD of Coastline Orthopedic Associates reinforced the importance of ICD-10 in EMA™, the award-winning orthopedic software programmed by practicing orthopedists.

“The CPT and ICD-10 calculation impressed me the most. EMA has actually given me much better knowledge on how the billing process works and this has been a very helpful feature,” he said. “We were told the change to ICD-10 will negatively impact our billing and that we would not get paid. In addition, the specter of the amount of data and knowledge needed to comprehend the more than 140,000 codes seemed like a huge task. EMA will produce the codes like a little genius, and that is a huge weight off our shoulders, both mentally and financially.”

Why ICD-10 Orthopedic System Accuracy Makes a Difference

Simply put, if your ICD-10 orthopedic coding is not accurate, you won’t get paid what you are legally entitled to. Many orthopedic EHR systems force you to search through the codes yourself. As you contemplate that prospect, ask the following questions:

  • How many patients do I see each day?
  • How much time would I have to spend searching for codes during each exam?
  • How much money is at stake?
  • How can I increase efficiencies?

For increased efficiency, orthopedic billing codes should generate effortlessly, right along with your exam notes, though intuitive coding and billing in orthopedic EMR systems aren’t quite as simple as it seems on paper. Utilizing an EMR system with proven success in ICD-10 coding will save you valuable time while making sure you get paid what you deserve.

ICD-9 has been around for decades, and the codes are short. You’ve likely memorized the ones that you use most. But before you simply plan on memorizing the ICD-10 codes, consider the effort it would take to learn a new language. Both German and Spanish have fewer words than the new classification of codes. Plus, the new alphanumeric ICD-10 codes are far more complicated than what you have been accustomed to, making memorization especially challenging.

Your focus should be on treating your patients and shouldn’t have to focus on coding accuracy.

Finding the right orthopedic EMR system means making sure it understands the ICD-10 language while utilizing structured data to help you achieve outcome-driven progress with data-driven results.

Why Orthopedic Templates Should be History  

Just as ICD-10 can be built into an EMR systems, so can specialty specific knowledge to once again increase efficiency and accuracy. Templates are often prevalent in EMR systems. While in theory, an orthopedic template may appear to be a good idea, in the end, the results will not be conducive for an efficient and effective workflow. Templates require added time, effort, are inflexible and don’t lend themselves to clinical thinking. They take precious time away from being able to face your patient and customizing templates can take hours. Your EHR system should have built-in medical knowledge, an adaptive learning engine, and touch-based approach to help eliminate the need for orthopedic templates that many EMR systems use.

Modernizing Medicine’s flagship EHR system, EMA, has these features and is template-free. Orthopedic client and Doctor of Osteopathic Medicine Steve Gorin of Institute of Sports Medicine and Orthopaedics commented, “A new patient note may take me a couple of minutes and a follow up note can take 15-30 seconds. Unlike how other general systems operate, EMA doesn’t include charts and templates that don’t pertain to me. I’m able to remain efficient and productive throughout my day.”

EMA doesn’t have orthopedic templates but rather has functionality and features that are much more advanced, dynamic and customizable. Orthopedic EMR templates are a thing of the past when it comes to EMA. We spoke with orthopedic surgeon Audley Mackel, MD of Associates in Orthopaedics, Inc. on this topic. Dr. Mackel shared, “Of all the EMR systems I saw, EMA had what I needed. I like how EMA is intuitive because it’s developed by orthopedic surgeons for orthopedic surgeons. The knowledge is already included without setting up templates.”

Having an orthopedic-specific EHR system that has ICD-10 built in and is free from orthopedic templates will have a strong impact on increasing efficiencies for all – practice, provider, patient and payments.

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The Author

Jason Weisstein, MD, MPH, FACS

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