ICD-10 Plan — Where to Begin If You Haven’t Begun

ICD-10 Plan — Where to Begin If You Haven’t Begun

“ICD-10 is coming! ICD-10 is coming!” This chant has likely been haunting your dreams as you prepare for the transition deadline occurring in just a few days. Your organization is nowhere near ready, but you cannot afford to delay reimbursements any longer than they need to be.

To extricate yourself from this proverbial rock and hard place, you are going to need a plan. Even in this 11th hour, a plan can help you pick up momentum and hit the ground running on October 1, 2015.

To help you piece together a strategy that will get you through these next few rocky months, here are ICD-10 transition plan steps that make drafting a comprehensive plan that much easier:

I. Get the Manual

There is no way to anticipate how ICD-10 implementation will affect your billing and coding processes if you do not have access to the actual coding guidelines. Obtain the materials as soon as possible and pore through them. You can assign other people to dissect every paragraph, but keep in mind – the people in charge of implementation must absolutely have working knowledge in order to help support others who will be struggling with ICD-10 implementation.

The new coding procedures are available in hard copies, digital media like DVD discs and online for free on the CMS.gov website here. There are also special smartphone apps that help you quickly browse and consult coding differences, as well as practice management systems and EHR systems that integrate automatic coding within them.

All of these resources are needed before you can truly get started.

II. Dissect Your Workflow

Your next step, which can actually be performed in the midst of studying the coding changes, is to analyze your own healthcare system’s workflow from registration to reimbursement and all the steps in between. Highlight the areas where coding is used and ICD-9 ancestry has the potential to creep back in. Electronic health records, paper claims, government reports and superbills all contain areas where new coding changes are relevant.

Also identify areas where roadblocks can appear that are not directly related to coding. For instance, perhaps physicians need to adjust the order in which, to describe condition details during their clinical documentation to make coding specifics easier.

III. Perform a Gap Analysis

A gap analysis is a deeper assessment of the above step. Once you have outlined in writing all the processes that currently use ICD-9 coding, you will need to identify the areas where the potential for the greatest friction can arise. The key things you want to eliminate are problems that lead to denied reimbursement and wasted staff time.

For instance, encouraging dual coding or employing “code translation” services from ICD-9 to ICD-10 may simply add unneeded complexity to the workflow. However, having someone who can audit forms for correct coding before they reach financial for submitting can reduce bottlenecks, even with the added step. Such a position can pull double duty by tracking errors and creating reports based on practices and codes that have the highest margins of error.

A complete gap analysis often requires the involvement of multiple departments in order to fully gather all of the information you need to cover each possible issue. Departments like registration to IT will all be able to contribute insights that weed out ICD-9 practices and help you identify deeper areas to target.

IV.  Locate Possible Solutions

In order to fix the problems identified in your gap analysis, you are going to need to deploy new solutions. Training teams and manuals can help on the personnel side in addition to solutions like the coding auditor as outlined above.

Most practices, hospitals and other healthcare providers are going to have to look into updated software and technology systems that comply with ICD-10 standards. Some systems can accomplish this through an upgrade, but many organizations are going to be completely reevaluating their system-wide needs with a solution that helps prevent coding mistakes and allows for easier ICD-9 to ICD-10 transition.

You will also likely need to order new paper forms for registration, billing and claims to ensure that ICD-10 compliant practices are carried throughout the workflow.

V. Focus on the Areas with the Most Potential for Change

CMS.gov rightfully advocates prioritizing the areas with the most potential for change. They recommend identifying the top 25 ICD-9 codes used most often and targeting them as the area of most scrutiny in employee training and coding practice auditing. Departments that see these particular codes most often should have greater emphasis placed on correct coding since they will be the most likely to create mistakes.

Once your team has become more accustomed to the top 25, you can begin working your way down to related codes and subordinate conditions. For example, many conditions require more than just three digits, so starting with the three digit examples then adding complexity will help ensure better retention.

VI. Get by with a Little Help from Your Friends

Remember that you are not alone! Countless other providers are going to be struggling with the exact same problems once the ICD-10 transition deadline hits. Share resources with them to find out about their successes or their unanticipated setbacks.

Agencies like the CMA itself have training programs to help make ICD-10 implementation less painful. One such program geared for small practices is available right on their website.

There are also plenty of outside consulting agencies that can evaluate your current practices and form a comprehensive gap analysis along with a list of potential solutions. Some software vendors even integrate ICD-10 implementation training right into the user experience, such as correcting ICD-9 coding and informing the user of their mistake. CureMD uses such features to help organizations ease into the transition with as little friction as possible.

This guide is by no means comprehensive, but it should push you in the right direction when it comes to crafting your organization’s own ICD-10 transition plan. Just keep telling yourself that the worst will be over in the beginning, it will slowly get easier over time and that there are plenty of resources to support you when you feel overwhelmed.


Author Bio

Daniel Schwartz is a content strategist who sheds light on various engaging and informative topics related to the health IT industry. His belief in technology, compliance and cost reduction have opened new horizons for people in the health care industry. He is passionate about topics such as Affordable Care Act, EHR, revenue cycle management, and privacy and security of patient health data. He can be contacted at @dschwartz20

Social Media in Medicine

Social Media in medicine is a controversial area in regards to the role of social media in the physician-patient relationship.

This is a large and ongoing debate for many people, whether social media can benefit the physician-patient relationship, or can cross the boundaries of appropriateness, and make things uncomfortable.

PatientsLikeMe is an example of a social media site that is working to capture patient-reported data for people with life-changing diseases. It is opening up new ways of testing treatments. And, of course, it relies on social media and other methods to ‘reach out’ and communicate with patients.
PatientsLikeMe has 16 disease communities, which in turn represent information from over 40,000 patients. The PatientsLikeMe framework exists specifically to address the integrated health and disease needs of each population it serves.
PatientsLikeMe serves as a platform for peers to interact with one another in a data-driven context. Patients are able to speak with other ‘expert’ patients that have already been through the decisions they are dealing with. Patients also evaluate the medications they are taking for their conditions.

One of the benefits of social media in medicine is that it gives patients information they might need. Social media has re-humanized the medical experience by creating an opportunity for individuals to share details of their “personal relationship” with their illness or medication.

However, it can be taken too far; a physician may not realize that posting on the internet is more public than hospital elevator chatter. And, while elevator chitchat disappears after the sound disperses, internet posts do not easily vanish.

Policies have been set up to ensure that social media in medicine is not taken advantage of. For example, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 prevents doctors from using email or text messaging, much less open platforms like Facebook or Twitter, to publicly communicate about a a particular patient’s care, without risk of being fined or fired.

The American Medical Association’s “Professionalism in the Use of Social Media” policy provides short and concise instructions on conduct in cyberspace. Mount Sinai Medical Center’s Addendum to Social Media Guidelinesare helpful in that they offer a dozen fictional but believable examples in which improper social media usage can occur, and they prompt readers to reconsider their own online interactions in a different light.

Some say that physicians should never interact with patients via social media; however, some think quite the opposite.
According to PricewaterhouseCoopers,41 percent of patient respondents said they would share information with health care professionals via social media and 61 percent said they would trust information from health care professionals received via social media.

Practitioners can also utilize social media to share news stories and information in their community about their practice. But sometimes the stories can turn into hype, and may risk going ‘too far’. Some physicians notice that they are getting friend requests from their patients. Where do you draw the line?

The key is how and where the physician answers the questions being asked on social media. The use of social media in medicine is much different for physicians, as compared to the average person’s use of social media.

If a patient asks a sensitive or urgent question, one should take the conversation off social media and respond with a phone call or some other direct form of communication. Some physicians even go so far as to text patients if that seems the best way to communicate.

In conclusion, it is a matter of personal opinion and judgment as to how far the physician should go in using social media in medicine as it relates to thepatient-physician relationship. The key to using social media with patients is being professional and respecting both their privacy and your own.

Contact Us:

If you would like more information about how Health Connexions™ can help you develop and implement a social media strategy, develop your website or manage your patient communications, please contact Adeola Fatuga at adeola@healthconnexions.com


Social Media Metrics

Size Isn’t Everything!

This point is similar to the idea of … is it quantity or is it quality?

Social Media Metrics

But, in the case of understanding social media and optimizing your social media metrics, it’s not good enough to just look at the volume of conversations.

If you know that 100,000 people are talking about your product recall … that would not be a surprise … given you had actually just had a product recall! 🙁

Or, maybe your brand or service is just one that ‘everyone’ talks about every day … because it is something that is used very frequently, has a long-standing history or has become a regular part of conversation.

It is important to ‘go beyond’ the numbers … and through enhanced Social Media Metrics (not just monitoring) … look at Sentiment and Passion.

What Social Media Metrics are important to you? … let us know your thoughts by posting on our blog, below.

Our full article is here:  http://healthconnexions.com/blog/market-research/social-media-market-research/social-media-metrics

Product Adoption Process

Traditional thinking in regards to Key Opinion Leaders (KOLs) has been focused solely on their product adoption process.  That is, in adopting a new innovation (for example, a new service, a new medical device or a new drug), most people think that when a Key Opinion Leader influences another physician to become a new prescriber or new user … this is seen to be occurring by simple imitation.

How do YOU view a Key Opinion Leader’s role in the product adoption process and usage of new technology?  … let us know your thoughts by posting on our blog, below.

Our full article is here:  http://healthconnexions.com/blog/strategic-consulting/product-adoption-process

Twitter Analytics

Twitter represents about 50% of all messages in the Social Media space; however, only 7 to 8% of all people are on Twitter.  So, in your quest to do better Market Research around Social Media, and not just do monitoring (which collects reams and reams of non-actionable data), the key question to ask is … “Is My Data Balanced and Representative?”  What are your thoughts on how Twitter impacts your Social Media analytics?

Our article is here:  http://healthconnexions.com/blog/market-research/twitter-analytics … but, let us know your thoughts by posting on our blog, below.

Key Opinion Leaders


In health care, in your field of medicine or disease area, as you develop your strategies to make changes or implement healthcare solutions, new products or services, how do you determine:  “What Makes a Key Opinion Leader a KOL?”

Our article is here:  http://healthconnexions.com/blog/market-research/key-opinion-leaders … but, let us know your thoughts by posting on our blog, below.

Care Management & Cost Management Services

To help you succeed in a changing healthcare environment, Care Management is critical.  Health Connexions conducts research, analysis, process flows and educational activities across the spectrum of health care issues.  

To implement real change, it is important to monitor and coordinate the delivery of health services to enhance Care Management and implement Cost Management strategies.  This ranges from Care Coordination to Disease Management to Care Delivery analyses for Life Sciences companies, Health Care institutions and the Government.


Market Research Services

In healthcare, there are few Market Research Companies like Health Connexions.  We service Life Sciences companies, Health Care institutions and the Government to study every stakeholder … from physicians to patients to employers. 

We have advanced methods in Social Media Market Research, as well as Qualitative and Quantitative Research, supported by Secondary Research or Data Analytics.

Healthcare Consulting Services

Health Connexions provides Healthcare Consulting based on our personal experience working INSIDE the system … in the trenches … to help you succeed in a changing healthcare environment. 

We service Life Sciences companies, Health Care institutions and the Government with solutions from Marketing Plans to Social Media Strategy & Solutions to Strategic Consulting, and more.   

Health Communication Services

Your Health Communication solutions must make an emotional connection with your audience.  People buy emotionally and rationalize intellectually – and healthcare is no different. 

Health Connexions has a full-service Communications Agency division to help you succeed in everything from Social Media to Digital Web & Multimedia Solutions to Medical Writing to Branding, and more.