practice management

All's Quiet on the ICD-10 Front ... So Far

It's been one week since ICD-10 went into effect, and although we don't expect to hear a whole lot on payment issues for another few weeks, things are going smoothly for PCC's pediatric practices.

“It's been remarkably mild, and everything is going as expected,” PCC's Pediatric Practice Management Consultant Chip Hart said. “We did our homework and our clients did their homework.”

By “homework,” Hart is referring to PCC's efforts during the last three years (despite broken former deadlines) to educate its clients – clinicians and staff – on using the new ICD-10 code set. PCC's Jan Blanchard, a certified pediatric coder and consultant on Hart's team, has criss-crossed the country offering ICD-10 weblabs and live events to PCC clients.

And like Hart said, all the hard work appears to be paying off. Of the minor issues, the majority have involved carrier system snafus.

“It hasn't been difficult to adjust to the new codes, and problems have been very few,” Hart said.

ICD-10 has also been a big topic of conversation on PCC's private client thread. Practices are using the group to show how they are handling specific ICD-10 issues. We expect this back and forth to help all PCC practices become more ICD-10 savvy using it.

“They're asking a lot of questions,” Hart said. “It's been a great vehicle for communicating with our clients.”

Early reports from other practice management vendors are also positive, according to members of the Healthcare Administrative Technical Association (HATA), the nonprofit trade association that represents the practice management system industry.

Minor problems so far include call spikes due to training and lack of preparation among some practices, or charge import errors by EHR partners who had not finished their updates to interface with practice management systems, HATA members said.

The Elephant in the Living Room

The elephant in the living room is around the adjudication of claims. Whether or not practices will be paid on time, or whether claims will be rejected or delayed is the big question. Unfortunately, it is unlikely we will have a big picture answer on this for another few weeks.

“The proof will be in the next two to three weeks when the claims come in,” Hart said.

That said, we want to help pediatric practices get out in front of payment delays as soon as possible by creating a tool that will tell us (and you) what is getting paid, and by whom, and what is getting denied, and by whom.

PCC has been closely monitoring the acceptances and denials of its own practices to tack the behavior of carriers across the U.S. Are they paying for the new ICD-10 codes? Which ones are they paying for? Is it a regional thing?

We're also collecting ICD-10 stories from all pediatric practices. To do this, we've created a quick, six-question survey that will help you tell us what's happening with your ICD payers:

Tell us: what is happening with ICD-10 at your practice? Have you run into any problems? We are looking forward to hearing from you!

Do you know the top mistakes of pediatricians?


PCC has been offering pediatric-specific software, support, and practice management advice for over 30 years. Our goal is to remove the obstacles so that pediatricians can serve communities, improve their practice, and remain independent.