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