By Abby Van Voorhees, MD, July 01, 2015
Are you ready for ICD-10? Hard to know if this is going to turn out to be a minor ripple or whether it will be truly disruptive. The on/off switch nature of it concerns me. With no gradual transition planned to assure a smooth switchover, potential for mess is the word that comes to mind. As one with a fair amount of skepticism about the ability of the government to get things right, I see this with the potential to be a real pain. So while the summer days are here with the temptation to laze the day away and take time for family and fun, we want you to pay attention to this potential disaster. Starting in this issue we are presenting a three-part series on ICD-10 to help shepherd you along. Alex Miller, MD, outlines the steps you should be taking to ensure that things go smoothly. ICD-10 will affect our practices from top to bottom. For example, we need to be sure to provide detailed documentation about the site of our procedures since location will be key to the correct choice of code. Billers need to know to be looking for this kind of detail too when they act on our behalf. Software companies also need to be up to speed. Alex Miller goes into the steps you should be taking throughout your practice to make this work. This is so important that we’ve created a series to help you get ready for the day that the switch flips so that we are all ready to roll. Be sure to read the first piece this month, and then be looking for the next two installments as well.
Mess also comes to mind when I step back and look at what has been going on with insurers. Narrowing networks, medication tiering, denial of modifier 25, and dermpath regulations are all contributing to our frustration and increased difficulty taking care of patients. We’ve touched on each of these topics individually over the years, so sadly these are not brand new. However, the intensity of these restrictions is growing by leaps and bounds. I’m sure that you would agree with me that it is certainly making it harder and harder to do our work. Basically it feels like an all-fronts attack. As networks narrow, access to patients is jeopardized; even if you do you get to see the patient, you can’t get medications approved; if your patient needs a biopsy getting it covered or interpreted by a dermatopathologist is a challenge...how are we supposed to practice, and does anybody even care? My daughter is applying to medical school this month, so I feel compelled to try to right this wrong before I leave this profession to those in her future class. There are indications that dermatology has been targeted by insurers as a cost-saving opportunity which is why we are especially feeling the heat. If you’ve been spared thus far, better read this piece to see what is coming. For those in the thick of it, it is good to know that you are not alone. All of these strategies are equally egregious, and must be challenged and fought. Sadly, there is no relief from the summer heat in the workplace this year.
Enjoy your reading.