Physician Practices

The impacts of ICD-10 and actions necessary to achieve compliance are primarily the same for all providers. However, there are differences regarding the implementation of ICD-10 between physician practices and other healthcare organizations.

For All Physician Practices

All physician practices will need to perform a gap analysis to determine the extent of the effort required for compliance. The required effort will vary depending on each practice's current system capabilities and the degree to which each practice has documented its processes. The ICD-10 implementation effort for physician practices is a little less than that of other healthcare organizations because physician practices will not initially have to implement ICD-10-PCS:

• ICD-9-CM will be replaced by ICD-10-CM
• Practices will continue to use CPT-4 for procedures codes instead of ICD-10-PCS
  

Physician Practices with EMRs

A physician practice that already has an electronic medical record (EMR) will need to conduct a gap analysis to evaluate the capabilities of its current EMR. The physician practice will have to conduct a system evaluation, including a due diligence assessment to determine whether or not its EMR vendor has the resources and time needed to develop an ICD-10-compliant release. The practice would need to decide between upgrading to a new version, if one is available, or selecting an ICD-10-compliant EMR from a different vendor.

For a practice running a proprietary legacy system, the gap analysis will need to estimate the amount of remediation work required for compliance. The practice would then have to decide whether remediating or replacing the proprietary legacy system is more prudent.

Physician Practices without EMRs

Because of the changes required by ICD-10 in documentation and coding, physicians will want to consider selecting and implementing an EMR. For a physician practice that does not have an EMR, a gap analysis is needed to evaluate and document current paper processes to determine the extent to which those processes can be supported by an EMR or if they will need to be reengineered. There are a number of factors that should be carefully considered before committing to an EMR. More detail is located on our EMR page.

Virtual Provider Networks/Business-to-Business Interoperability

Hospital chains and hospital systems are scrambling to figure out how to make their current admitting and referring physicians (and hopefully other community physicians) interoperable to not only share patient data but to be business-to-business (B2B) trading partners. To accomplish this, some hospital systems are selecting and providing EMRs to their physicians at little or no cost, which is now permissible under the Stark regulations. More information can be found on this topic on our Hospital-Physician Network page.