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ICD-9 to ICD-10 move may cause retirements, practices to close

Many physicians feel that the implementation of the ICD-10 code list will not only cause practices to go out of business, but push physicians to retire.

With the healthcare community having to tackle numerous government mandates essentially all at once, the transition from the ICD-9 to ICD-10 code list could be the final straw for many physicians and small practices. At least, that's what David Heck, M.D., and Bill Marks, M.D., think.

Heck -- an orthopedic surgeon at Texas Orthopaedic Surgical Associates, a seven-physician practice in Dallas -- said he believes the move from ICD-9 to ICD-10 will not only disrupt and slow down workflow, but also push many doctors and physicians -- mainly older ones -- into retirement.

David Heck, M.D., orthopedic surgeon, Texas Orthopaedic Surgical AssociatesDavid Heck, M.D.

"I'm at the point in my career where if I have to retire because everything collapses, then I can do that. Not everybody is in that position. And, clearly, on the other side of the coin: The patients. That's going to be the biggest problem if they lose physicians," Heck said. "We're already talking about not having enough physicians to address current needs. This doesn't sound real good."

ICD-9 to ICD-10 brings credit worries

Marks -- an ophthalmologist in Canton, Ga., who has run a solo practice for 13 years -- added that he believes in addition to many physicians retiring due to the problems ICD-10 codes will cause, many small practices will also go out of business, causing physicians to look for work at larger healthcare organizations.

Bill Marks, M.D., ophthalmologistBill Marks, M.D.

"We need diversity in everything we do," Marks said. "We don't want huge, monopolistic healthcare systems. We want choices for our patients."

Marks added that many doctors are being advised to take out a line of credit in order to stay in business because it's up to the practices, not the government, to take care of the costs of getting ready for the transition from ICD-9 to ICD-10. Further, reimbursement may be delayed if providers face rejected claims due to incorrect ICD-10 coding.

"I've not had a line of credit in 20 years," Marks said. "So, now, this government mandate is forcing me to perhaps have to take out a line of credit to stay in business? It's amazing that that would even be suggested."

With ICD-10, feds add to frustration

Robert Tennant, health information technology policy director, Medical Group Management Association Robert Tennant

Robert Tennant, director of health information technology policy at Medical Group Management Association (MGMA), a professional organization in Englewood, Colo., said that while there may be an increase in the number of physicians who retire and a decrease in the number of smaller physician practices after the move from ICD-9 to ICD-10, he does not think it will be overwhelming, nor that the expanded code set should shoulder all the blame.

Instead, ICD-10 adds to a long-standing weariness from practices. "[Physicians are] frustrated with sort of the government intervention in healthcare," Tennant said. "It's meaningful use; it's PQRS; it's also the commercial health plans. There are many, many requirements and programs, narrow networks, you know, black-box edits. It's a very frustrating profession."

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Tennant explained that physicians love taking care of their patients, but hate the administration of healthcare. "And I think ICD-10 is yet another example of government mandate without any clear benefit for the physician or the patient," Tennant said.

And this, Tennant explained, has been a repeated concern when it comes to government programs: The promise of improved patient outcomes with scant evidence of it actually working, he added.

Let us know what you think about the story and the transition from ICD-9 to ICD-10; email Kristen Lee, news writer, or find her on Twitter @Kristen_Lee_34.

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