Dr. Linda Girgis' Response to My Questions and Comments About “ICD-10 Glitches”

The following is a response from Dr. Linda Girgis to my comments and questions on her blog post titled 6 glaring and disruptive ICD-10 glitches posted on the Health Care IT News website. 

Not surprisingly, Dr. Girgis responded in very complete and professional manner. Her clarifications make a lot of sense and I can’t say I disagree with any of her follow-on points. Dr. Girgis’ entire, unedited response to me follows. (I have her permission to post it)

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OK, that is a fair response. You have valid points. Yes, not all of these things are directly attributable to ICD-10. And they may seem like small points, but in totality have been quite disruptive to the daily work-flow in my office. I'm just going to respond to your points here. I'm not sure if you want to share them along with your post or we can have a debate afterwards.

1. True. However, this requires us to have two standards for coding: one for governmental insurances and one for commercial insurances. Definitely a time drain, esp. while treating patients at the same time. But, you are right: some of this is due to the learning curve.

2. The clearinghouse is Gateway EDI.....we are still looking into why this happened. I think though, it goes back to #1 and having two standards for billing. I think that might be tricky for IT.

3. There was an equivalent ICD-9. It was a Medicaid HMO plan. And they sometimes deny claims even with a valid referral.

4. You are correct here as well: it has nothing to do with ICD-10 other than their systems were down up-grading for ICD-10 so we were not able to perform this task. So, indirectly it played a role.

5. No, she is good at multi-tasking so she was doing other work. I don't recall which carrier so don't want to falsely accuse anyone.

6. One specific example was that she was calling on a previously denied claim and was told it needed to be resubmitted using ICD 10 codes. This was a visit from 3 months ago. So, I think we can both argue whether or not it was ICD-10 related and I doubt either of us would win here.

I have to admit that when I first saw this email I was concerned what you were going to say. I have been ruthlessly attacked by people who have disagreed with me on issues in the past. But, you refuted my points respectfully and with valid points. I truly appreciate that.

I remember one Kareo Chat we both participated in before. I think you are the one who made me not "hate" ICD-10 so much. I think we have different viewpoints here and that is OK. You see it from a system viewpoint and how it can improve things. And you are right. I see it from the front-lines in real time while working through patient encounters. And I have to tell you, that system often doesn't work how it is supposed to. I expect if it did, you and I probably would agree on most things.

I know we have only "met" on twitter, but I have always respected your opinion and the things you are saying (I don't always agree with them).

And I know you are writing this to counter my claims and that is OK as well. I really hope this opens up a discussion about the topic and real solutions to very real problems can be found to what is happening on the front-lines.

Hope to know you more in the future and best wishes!

Linda