It's the new year, and you are mapping your business goals, marketing plan, and budget for 2014. You have looked at your web marketing, your advertising campaigns, and your office overhead and are making strides to advance your practice and capture as much business opportunity as possible. Your software systems factor into your budget and marketing processes, but you may not appreciate how your software and related information technology can contribute to practice revenues. If insurance billing represents a component of your practice, some important areas to consider in 2014 are Meaningful Use (MU) payments and ICD-10. Electronic health record (EHR) systems can help your bottom line in both of these areas.

If you are a participant in Medicare or Medicaid and collected MU data in 2013, the deadline to attest for Stage 1 Meaningful Use payments is February 28. If you started with 2013 data you could get a total of $39,000 for the remainder of the incentive program. If you have not begun your MU process but still want to benefit from MU payments, you may be eligible for up to $24,000 if you attest for 2014 through 2016. More good news: You do not need to start collecting MU patient data until October 1, 2014 to still be eligible for 2014 MU payments. If you do want to benefit from the MU program, you must begin the process in 2014, and to avoid the penalty, you need to attest by October 1 (start collecting data by July 1, 2014).

Depending on your software (for instance, whether you use cloud-based tools with lower upfront hardware costs, client-server systems with more significant information technology infrastructure, or some combination), such MU payments may significantly offset or even completely cover the cost of implementation and service of your EMR system. In other words, the EMR system that brings your documentation and consultation process into the 21st century might pay for itself.

For example, one 2014 MU requirement involves exchanging information with patients through online portals to allow them to access their information online. This may allow you to improve your post-consultation follow up communication, leveraging this requirement to enhance your practice's engagement with cosmetic patients as well. In fact, I believe that many of the tools being put into EHR systems to comply with MU requirements may actually create substantial benefit to cosmetic practices. These elements including items such as smoking cessation and obesity counseling. These may actually help improve patient selection, outcomes, and overall wellness—advantages to any conscientious cosmetic surgeon's practice.

For many practices, the most daunting change to their workflow in 2014 will be the transition from ICD-9 to ICD-10 coding on October 1, 2014. The number of unique codes to document patient diagnoses will mushroom from 13,000 to more than 68,000. Some practices may see substantial lost revenues if they are not well equipped to deal with these changes. As tempting as it is to procrastinate on this mandatory change, you will not be able to avoid it. If you do not have a plan in place soon, you could find yourself taking steps to save your practice when reimbursements are declined as a result of inaccurate coding.

You hope your EHR system vendor (if you have one) has you covered, but not all approaches to ICD-10 are the same. Many are inadequate and could eventually cost you more. Conversion software, General Equivalence Mappings (GEMs), or tools for translating codes from ICD-9 to ICD-10 can lack accuracy and can be a big drain of time, potentially adding minutes to each exam and disrupting the practice.

You do not want to lose revenue or practice momentum when ICD-10 starts, and your vendors want to help you to not just survive, but thrive in the new paradigm.

Modernizing Medicine is one EHR vendor with a tool to automate the coding process. To learn more about it, visit

tim sayed

Tim A. Sayed, MD, FACS is Medical Director, EMA Plastic Surgery™ and EMA Cosmetic™ at Modernizing Medicine. He is also an Executive Committee Member of HIMSS EHR Association.