“Bent, Breaking, and Broken”

By: Ryan P. Ames, OD, MBA and Charles B. Brownlow, OD, Medical Records Consultants

ICD-10 Has Arrived…

For the procrastinators among us (or for Rip Van Winkle, OD), ICD-10 is in full swing as of October 1, 2015. It is two years after its original ‘due date’, so we’ve all had plenty of time to prepare, but with the ups and downs; “it’s going to be delayed a year”, “It’s going to be delayed two years”, etc.; it’s no surprise that many doctors and staff put off their preparation, almost expecting a last minute reprieve.  The ‘last minute’ has passed…No reprieve…No excuses.  ICD-9 codes must be used for all services provided on or before September 30, 2015, even if the claim is submitted after October 1.  ICD-10 codes must be used for all services provided on or after October 1, 2015.  We have no idea how you will manage without resources, but there are tons of resources available.  Our recommendation is to buy the AMA version, 2015 ICD-10 (about $100, amastore.com, 800-621-8335), and possibly supplement it with the AOA Codes for Optometry (aoa.org/marketplace. 800-365-2219).  The AOA document is a ‘condensed’ version of the full ICD-10, which will be useful, but no one should enter this brave new world of coding without the full version of ICD-10 codes.  We’ll continue to help you with the occasional strange diagnosis, but we certainly won’t be able to provide a ‘look-up service’ for doctors who don’t care to buy the actual references.

PQRS Reporting Switches to ICD-10 on October 1, Too…

It was not until September 23 that we got our first question about the use of ICD-10 for PQRS.  A quick online search provided us with key information.  Of course all the PQRS measures are based on each patient’s diagnosis, so ICD-10 codes must be used for PQRS reporting on and after October 1, 2015.  AOA was all over this one, too, and offers a new chart, with ICD-10 codes replacing the ICD-9 codes.  It can be downloaded at:


You’ll find lots of information regarding PQRS reporting at aoa.org/pqrs.  There are still a few ODs who are not participating in PQRS, but that will soon be nearly impossible.  Health care leaders are focusing on outcomes and are rewarding doctors based on reporting…In some cases, requiring doctors to report in order to even participate in their plan.  Those rewards will soon turn to penalties for those choosing to not report.

As an aside, there are lots of reasons to be using electronic health records in 2015 and beyond, and PQRS reporting is certainly one of them.  The use of EHR permits nearly automatic, once per year reporting of PQRS compliance via a ‘registry’, rather than the ‘claims based’ reporting required for doctors with paper charts and claims.  If you are still using paper charts, it’s definitely time to consider going electronic.

The Changing of the Guard—PMI, LLC. Became Foresight, LLC on October 1

After nearly five years of working together to assist doctors and staff with their issues related to medical records, coding, life with third parties, etc., Dr. Ryan Ames and Dr. Charles Brownlow have formally merged their efforts.  On January 1, Dr. Ames will be taking over the lion’s share of answering emails, writing articles, providing education, etc., while Dr. Brownlow will continue to provide support as needed.  The current plan has Dr. Brownlow  involved with the new venture, Foresight, LLC, through the end of 2018, though the extent of his involvement will definitely taper off significantly over the next three years.

When asked if this change means that he will be retiring from the profession he’s been involved with for nearly a half century, Dr. Brownlow responded, “I know, I know…I don’t look old enough to retire, but the calendar doesn’t lie.  I certainly am not ‘old’, but 1946 was a long time ago.  I will continue to be devoted to my colleagues and this profession for several years, but in a greatly reduced capacity.  Of all the people that have said ‘I’ll believe it when I see it’, when considering my retirement, my wonderful wife, Sherry, has been the most insistent.  It really is time for us to share more time together and with our children, grandchildren, and friends.  I love all of you (well, most of you), and I’ll be around if you really need me.  I’m confident that won’t be often, though, and I’ll bet it won’t be for long.  According to the Book of Ecclesiastes…”For everything there is a season”.  For me, the season is now autumn!  Thanks for all the support and friendship so many of you have provided me during my career… Optometry is small in numbers but it has proven itself enormous in accomplishments!  Please make me proud by always pushing the envelope of the scope and range of the services you provide to each patient you see.

Remember…As an association member, you and your staff are able to send questions directly to Dr. Ames at drames@pmi-eyes.com or Dr. Brownlow at drbrownlow@pmi-eyes.com

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