ICD-10: Where to Start

October 1, 2014, marks the compliance date for ICD-10.  Since the government first announced the move to ICD-10, healthcare organizations have experienced a familiar range of emotions – anger, anxiety, bargaining, denial.  Most organizations are finally moving into the acceptance phase.  However, despite the compliance date being moved from 2011 to 2014, many organizations either haven’t made much progress on their implementation plans or haven’t started making one yet.  Based on a recent study by the MGMA, less than 5% of practices reported making significant headway when rating their overall readiness for ICD-10.  This gap poses significant risk, considering that ICD-10 can affect both short- and long-term cash flow and overhead costs if not mitigated appropriately.  To that end, preparing for the change to ICD-10 now is essential.  The obvious first question is, “Where do we start?”

Establishing the Framework

When addressing any new project, thinking through the various steps – from discovery to planning to testing to implementation – will help your organization identify key areas of concern, as outlined in the figure below.Key Areas of Concern_ICD10_Final

When establishing an ICD-10 implementation plan, it will be important to:

  • Evaluate existing IT systems/interfaces, clinical and financial work flows, and reports that currently use ICD-9 codes in order to develop the transition plan to ICD-10.
  • Develop a strategy for ways to improve diagnosis capture and how the data will be used.
  • Assess training needs and develop programs to support both the initial and any ongoing training before and after October 1, 2014.
  • Manage expectations regarding productivity loss, and focus on change management.

It will also be important to ensure that a sufficient budget is available for training, resources (e.g., third-party coders to help offset increased coding demands during the first 30 to 90 days of the ICD-10 implementation), and unforeseen financial contingencies.

Tailoring the Plan

Thinking through the life cycle of an ICD-10 code can help define the scope of your project plan and potential areas of impact.Plan Lifecycle_ICD10_Final

Beyond the standard considerations, such as whether your practice’s IT systems, vendors, clearinghouse, and payors will be able to support ICD-10, it is also critical to recognize the less obvious ways the transition will impact staff.  One example is the effect of increased documentation standards on physician productivity, at least at the outset, and the subsequent impact on physician compensation plans that are driven by volume metrics.  A second example is the additional communication between coders and physicians to identify the correct diagnosis codes during the first 90 days.

Finally, looking at the experience that other countries have had in implementing ICD-10 can help identify impacts on staffing, finances, IT systems, and partner organizations.  The sooner your organization begins evaluating the impact of ICD-10, the sooner you can develop your approach and risk mitigation strategy.

Conclusion

Ultimately, the single greatest step in successfully making the transition to ICD-10 is to act now.  Your leadership team must take the time to recognize the challenges the organization will face and devise a strategy to address them.  In addition, leadership must champion the cause so that the organization as a whole gains an understanding of the reasons needed to make this change.  By connecting with others who are also living through the pain of ICD-10, you can leverage the support of the collective to make it through this experience. Act now so your organization can position itself to ensure a well-planned conversion to ICD-10.

This entry was posted in Financial Performance, Legislative & Regulatory Issues, Strategic Planning and tagged , , by Jason Meaux. Bookmark the permalink.

About Jason Meaux

Jason offers 15 years of experience in healthcare information technology (IT), encompassing both practice management and electronic medical record systems. He has focused his practice on IT strategy, project/program management, system selection/implementation, and organizational change management. He also has experience performing revenue cycle assessments, assisting with contract negotiations, and developing financial models of system costs/benefits. At ECG, Jason manages a team of consultants, serves as the internal project director for our Healthcare IT practice’s project management engagements, and is the firm’s Epic expert. In addition, he also leads ECG’s Project Management Affinity Group. Previously, he worked for Epic Systems Corporation as a Software Developer Team Lead for the Resolute Professional Billing and EpicCare Ambulatory products. Jason has also worked at the University of Washington as the EpicCare Implementation Manager and Architect. He has obtained certifications in Epic’s Resolute Professional Billing and EpicCare applications and is also a NextGen Enterprise Practice Management (EPM) Certified Professional. Jason is a board member of the Washington State Chapter of Healthcare Information and Management Systems Society (HIMSS) and a Certified Professional in Healthcare Information and Management Systems (CPHIMS). He has a master of business administration degree from the University of Washington and a bachelor of science degree in computer science from the University of Louisiana at Lafayette.

3 thoughts on “ICD-10: Where to Start

  1. Pingback: HIMSS14: Showcasing the Latest and Greatest in Health Information Technology | ECG Management Consultants, Inc.

  2. Pingback: The ICD-10 Transition: Updating Payor Contracts | ECG Management Consultants, Inc.

  3. Pingback: Six Common Misunderstandings About the Value of HIT | ECG Management Consultants, Inc.

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