Face to Face: Chuck Buck

BC Advantage (BCA): As publisher of ICD-10monitor.com, what are the main issues you see industry professionals facing in 2013?

Chuck Buck (CB): In the post-ICD-10 world, it would appear that many healthcare providers will be challenged with the daily implementation of ICD-10, particularly as it relates to reimbursement  which, in turn, impacts revenue, cash flow and profitability. This post-I-10 environment could feature the shuttering of a number of hospitals, practices and vendors that simply will be noncompliant after Oct. 1, 2013. Even as providers are expected to be grappling with I-10, they also will be confronting, in 2013, accountable care organizations, value-based purchasing, meaningful use, electronic health records and the continuing acquisition of hospitals by payer entities.

BCA: What are the main questions people are having with understanding ICD-10?

CB: It's not so much the questions people have in their understanding of ICD-10, but rather the complexity of the issues surrounding 1-10. For example, it's the increase in the number of code sets resulting from specificity (a jump of some 155,000 codes), the lack of a direct crosswalk from ICD-9 to ICD-10, the expanded vocabulary of anatomy and physiology brought about by advances in research, and the sheer ubiquity of ICD-10 across all hospital departments. 

BCA: With ICD-10 implementation so far out (826 days at the time of interview) why should people start their education on this topic now?

CB: We have found through our "Talk-Ten-Tuesday" podcasts that practices are not as far along on timelines as various associations recommend. The importance of starting now is that, given the amount of time left to go (826 days), there are numerous pieces of the puzzle on which we should be working. Vendor readiness is one of them. Imagine if at this same time next year, you find out that five of your 10 vendors won't be ready. Wouldn't each practice like to have known that a year ago? That way they could have made the necessary vendor changes in advance and not rushed.  Education of physicians is also key. Companies such as MedLearn, can review current documentation practices and help physicians understand the importance of precise documentation in the record so coders will be able to code correctly in ICD-10. it will take time to understand the audit and education processes, plus the improvements/changes that will need to take place.

BCA: How will ICD-10 affect the everyday coder in a physician environment?

CB: Today's coder will need to become more of a clinical coder. It will take more time to read and review documentation and apply the numerous regulations in order to assign the most accurate alphanumeric codes.

As reported by the HIMSS (Healthcare Information and Management Systems Society) semi-annual 5010 Industry Readiness surveys, there is concern among providers about the 5010 compliance readiness of trading partners such as payers, vendors and clearinghouses. Can you give us any further information and clarification on this?

At this particular time all vendors, payers and providers are to be ready by Jan. 1, 2012. It is important that each practice perform a review of all their vendors. We have found that vendors are all at a different point of readiness, and each will need to be monitored by the individual practice or facility to ensure things go smoothly. At ICD10monitor.com we help practices and facilities understand the steps necessary to ensure vendor readiness, and we do this through webcasts, articles and white papers.

In your opinion, why do you think it has taken the USA so long to implement ICD-10 compared to the rest of the world? (Australia implemented ICD-10 for mortality reporting in 1998 and completed its implementation for morbidity reporting in 1999 and in 2002, Canada's two most populated provinces moved to adopt the new classifications)

I believe there has been significant pressure on Congress by provider and payer interests over the years to delay the implementation of ICD-10. It literally took an act of Congress to mandate the transition.

BCA: Once implemented in October 2013, will there be any grace periods to allow for errors?

CB: It is our current understanding that there will be no grace period.

BCA: What advice would you give to our readers if they find themselves ready for ICD-10 but their office is still yet to adopt any planning strategies?

CB: With claims being denied as of Oct. 1, 2013, this will affect revenue to that practice. With the aid of an outside company such as MedLearn, however, they can provide education for physicians and practice managers alike, helping them develop a planning strategy.

BCA: How much time and money should the average coder/biller allocate if they are paying for their own further education to be ready for the ICD-10 implementation date?

CB: It depends on the current proficiency level of each coder. There are online classes, training the trainer within a facility and boot camps. Make sure your I-10 training plan is meeting your objectives and matching your financial situation. Invest in yourself.

BCA: What would you say best separates your ICD-10monitor.com from other companies offering ICD-10 information?

CB: ICD-10monitor is an originator, not an aggregator, of news and information. Our content is free. There is no subscription cost. Our editorial board is comprised of both payers and providers. We produce a live 30-minute podcast called "Talk Ten Tuesday" to provide even more I-10 news and information. ICDUniversity produces Webinars, and through our University Book Store, visitors can purchase e-books and download on-demand Webinars.

BCA: Tell us about www.racmonitor.com. What is your objective with this website?

CB: RACmonitor.com was founded to be the nation's single most important source of RAC news and information. Today, we have a circulation of more than 30,000. We alert our base to RAC activities in each of the four RAC jurisdictions, we report on successful appeal cases and we help our readers understand such complexities as extrapolation and predictive modeling - tools used by the RACs and other auditing entities targeting providers' Medicare and Medicaid billing. And every Monday, we supplement our bi-weekly e-newsletter with a live 30-minute podcast called "Monitor Monday."

BC: You're a very busy man with your two websites providing online news and information about major regulatory environments as well as hosting two popular weekly podcasts - how do you maintain all of those balls in the air?

CB: I am fortunate to have the support of a group of extraordinarily talented and dedicated individuals.

BC: What are some of the exciting things you will be offering on your websites in the near future?

CB: Wait and see!