Five Practical Ideas to Aid in Your ICD-10 Transition

February 08, 2014

Five Practical Ideas to Aid in Your ICD-10 Transition

October, 2014 is coming—the implementation date for ICD-10. It may seem comfortably distant, but it really isn't; not in view of the magnitude of the challenge, and the widespread impacts to the medical industry, your practice, and your ongoing financial health. ICD-10 preparedness now looms large as the single most important industry transformation in the modern medical era, and practitioners increasingly ignore it at their own peril.

The ICD-10 code set is eight times the size of ICD-9, but the challenge doesn’t end there; the new codes are now alphanumeric, structured differently, provide for laterality, and make more extensive use of diagnosis groupings. It’s not just a new language, it’s a new way of doing business. The challenge in migrating to ICD-10 is daunting, but you can take a few simple steps to help manage the migration with aplomb.

Here are five practical ideas that can help minimize mistakes, shorten the learning curve, and minimize disruptions to your services, your patients, and your revenue cycle.

One: It’s Not a Burden, It’s a Project

No change of this magnitude can happen smoothly without planning, and no plan of any complexity can succeed without a designated individual to champion the process within the organization. You’ll need to appoint a highly-qualified person to select and lead the transition team, prepare a transition plan, evangelize the project, and take responsibility for the transition metrics. This individual will need the skills of a project manager and the authority of a director. Among the tasks and responsibilities instrumental to this role are the following:

  • Document the current operational and actuarial status of the organization.
  • Develop a strategic roadmap and a tactical project plan to manage ICD-10 migration throughout the organization.
  • Engage key stakeholders about the need for, cost of, and expectations associated with ICD-10 compliance.
  • Engage and track information technology and training resources.
  • Develop a set of metrics to measure the success of the transition.
  • Report migration status on an ongoing basis to key stakeholders and executive management, including key deliverables, budgets, compliance metrics, and actuarial trajectories.

None of this is divergent from standard project management best practices, but the stakes and the risk for this particular project are very high, and none of it is optional.

Two: Eliminate Guesswork with a Gap Analysis

A formal gap analysis is an excellent tool for identifying specific areas of concern within a project or an organization.  Gap analysis involves determining, documenting, and approving the variance between business requirements and current capabilities, and it will help you to gain a detailed understanding of how ICD-10 will impact your organization. Once these variances have been identified, they can be addressed with specific, targeted responses.

Areas to consider in a gap analysis include, but are not limited to:

  • Coding expertise and staffing levels
  • Information technology capacity and usage trajectory
  • Claims processing, including documentation requirements
  • Analytics and fraud detection
  • Enrollment, eligibility, and benefits

A thorough gap assessment will tell you precisely what is needed, when it is needed, and why. From there, you can develop a timeline for remediation, as well as accurate cost estimates.

Three: Take Advantage of Educational Opportunities

Specialty associations, such as AHIMA, AMA, MGMA, and a variety of billing associations will be offering training programs and related information. Take advantage of these opportunities. The learning curve for ICD-10 is steep, and the sooner you begin training your staff, the sooner your organization will benefit.

One of the most important challenges to your organization will be the inevitable productivity impacts that training necessitates. This can be mitigated somewhat by the judicious use of online educational programs; many of these are available off-hours and off-premises, including Industry webinars that focus on specific aspects of the ICD-10 transition. Monitor the topics of these webinars and ensure that your staff members attend those most appropriate to their individual roles and responsibilities.

Four: Enlist Technology to Ease the Transition

Accurate coding was once the exclusive domain of highly skilled professional coders, and while they remain critical to an efficient accounts receivable process, it is also true that modern technology can be of tremendous assistance. Computer-Assisted Coding (CAC) is a highly sophisticated and mature technology that derives and assigns appropriate medical codes automatically by scanning and scrutinizing clinical documentation. The process saves time, reduces errors, and streamlines coding operations. Many CAC systems are already ICD-10-compliant, and they can serve not only as a time-saving assistant, but as a learning tool and reference as your staff ramps up.

Chances are good that in addition to staff education and process improvements, you’ll need to upgrade your information technology infrastructure. At the very least, software upgrades will be necessary for ICD-10 compliance, and these may necessitate newer, more capable hardware as well.

Five: Don’t Go it Alone

Synchronizing the training of the coding staff with the capabilities of new technology is likely to be difficult, and it may be advisable to employ outside coding assistance to bridge the gap. The United States is late to the ICD-10 transition, and there is a great deal of reliable ICD-10 coding expertise available from business organizations that have already assisted other countries in the transition. They can provide expertise, guidance, and ease the increased workload that the transition is certain to cause for your professional coding staff.

You should also consider consulting with an expert in ICD-10. They’ll provide training and timeline recommendations, alert you to common pitfalls, and will probably save you far more in avoiding mistakes than they are likely to cost.

None of these items is rocket science, but ICD-10 is not just another shift in standards. It’s a tectonic shift in the entire healthcare sector, and it needs to be taken seriously. Plan for it seriously, take a common-sense approach, and get started today. October 2014 will be here sooner than you think.

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